Provider Demographics
NPI:1144368168
Name:COUNCIL OAKS COMMUNITY OPTIONS LTD
Entity type:Organization
Organization Name:COUNCIL OAKS COMMUNITY OPTIONS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOROWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-646-0717
Mailing Address - Street 1:11901 TOEPPERWEIN RD STE 1001
Mailing Address - Street 2:
Mailing Address - City:LIVE OAK
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3158
Mailing Address - Country:US
Mailing Address - Phone:210-646-0717
Mailing Address - Fax:210-599-9789
Practice Address - Street 1:11901 TOEPPERWEIN RD STE 1001
Practice Address - Street 2:
Practice Address - City:LIVE OAK
Practice Address - State:TX
Practice Address - Zip Code:78233-3158
Practice Address - Country:US
Practice Address - Phone:210-646-0717
Practice Address - Fax:210-599-9789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001008983Medicaid
TX001008985Medicaid
TX001008988Medicaid
TX001008987Medicaid
TX001008982Medicaid
TX001008984Medicaid
TX001008986Medicaid
TX001008183Medicaid
TX001008989Medicaid