Provider Demographics
NPI:1861841256
Name:VENUS SPRINGS ADVOCATES FOR COMMUNITY ENRICHMENT, LLC
Entity type:Organization
Organization Name:VENUS SPRINGS ADVOCATES FOR COMMUNITY ENRICHMENT, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-316-0184
Mailing Address - Street 1:11043 CASPIAN SPG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5990
Mailing Address - Country:US
Mailing Address - Phone:210-379-0355
Mailing Address - Fax:
Practice Address - Street 1:17000 SAN PEDRO AVE
Practice Address - Street 2:SUITE 1103
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-2231
Practice Address - Country:US
Practice Address - Phone:210-379-0355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101YM0800X101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty