BEHAVIORAL SUPPORT CENTER, LLC


Address: 8546 Broadway St Bldg C, Bldg C Suite 200, San Antonio, TX 78217-6376
Phone: 2105261806

BEHAVIORAL SUPPORT CENTER, LLC (NPI# 1922372267) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922372267
Entity Type Organization
Organization Name BEHAVIORAL SUPPORT CENTER, LLC
Other Organization Name BSC
Practice Address 8546 Broadway St Bldg C
Bldg C Suite 200
San Antonio
TX 78217-6376
Mailing Address 8546 Broadway St
Ste. 200
San Antonio
TX 78217-6376
Practice Telephone 2105261806
Practice Fax Number 2105477984
Mailing Telephone 2105261806
Mailing Fax Number 2105477984
Enumeration Date 2012-03-05
Last Update Date 2016-05-25
Authorized Official Name MR. JOHNNY R. YBARRA (CEO/EXECUTIVE DIRECTOR)
Authorized Official Telephone 2105261806
Authorized Official Credential LCDC, MAC, SAP,
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 103K00000X Behavioral Analyst Behavioral Health & Social Service Providers
N 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
LCDC TX: 12124 TX Behavioral Health & Social Service Providers
Y 174400000X Specialist Other Service Providers

Other Provider/Organization Names

Other Name Type Code
BSC Doing Business As Name - Organization

Office Location

Street Address 8546 BROADWAY ST BLDG C
BLDG C SUITE 200
City SAN ANTONIO
State TX
Zip Code 78217-6376

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1083241129 Jena Lalley Nurse Practitioner 8723 Botts Lane, San Antonio, TX 78217 2020-03-26
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1255996815 Chelsey Lynn Guy Dental Hygienist 10231 Kotzebue St., San Antonio, TX 78217 2019-05-08
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1487133781 Rebecca Rendon Registered Nurse 8610 N. New Braunfels Ave, Ste. 405, San Antonio, TX 78217 2018-08-08
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Taxonomy Information

Taxonomy Code 174400000X
Grouping Other Service Providers
Classification Specialist

Taxonomy Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974.

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NPI Name Taxonomy Address Enumeration
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1851753396 Coral Ramirez Camacho Specialist 7827 Clos Du Bois, San Antonio, TX 78253-4880 2016-03-23
1174984371 Crossover Health Specialist 3838 Rogers Rd, San Antonio, TX 78251-3662 2016-03-15
1033585948 Job Adventures Specialist 4606 Centerview Ste 200, San Antonio, TX 78228-1205 2015-08-14
1790168417 San Antonio Head & Neck Surgical Associates Specialist 926 Booklyn Ave, San Antonio, TX 78215-1637 2015-06-30
1255738514 Amy Beth Flores Specialist 7134 Washita Way, San Antonio, TX 78256-2339 2014-12-01
1730582263 Womens Center At Westover Hills Specialist 1315 N. Ellison Dr., San Antonio, TX 78251 2014-09-29
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Competitor

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City SAN ANTONIO
Zip Code 78217

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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