Provider Demographics
NPI:1730444134
Name:RIDGEVIEW ENTERPRISES
Entity type:Organization
Organization Name:RIDGEVIEW ENTERPRISES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:HANI
Authorized Official - Middle Name:
Authorized Official - Last Name:TALEBI
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-252-0303
Mailing Address - Street 1:1015 BEECAVE WOODS DR
Mailing Address - Street 2:SUITE 207E
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6762
Mailing Address - Country:US
Mailing Address - Phone:512-328-3900
Mailing Address - Fax:512-328-3902
Practice Address - Street 1:1015 BEECAVE WOODS DR
Practice Address - Street 2:SUITE 207E
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746-6762
Practice Address - Country:US
Practice Address - Phone:512-328-3900
Practice Address - Fax:512-328-3902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34463103TS0200X
TX34137103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty