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Organization
OUR LADY OF THE LAKE UNIVERSITY
Active
Organization
OUR LADY OF THE LAKE UNIVERSITY
Active
Other names
Community Counseling Service
Organization subpart
No
Provider details
NPI number
Authorized official
BERNADETTE H SOLORZANO (CLINIC DIRECTOR)
(210) 434-1054
Entity
Organization
Contact information
Practice address
590 N GENERAL MCMULLEN DR, 3, SAN ANTONIO, TX 78228-6205
(210) 434-1054
(210) 434-1380
Mailing address
590 N GENERAL MCMULLEN DR, 3, SAN ANTONIO, TX 78228-6205
(210) 434-1054
(210) 434-1380
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144674201
—
TX
Enumeration date
01/10/2007
Last updated
06/09/2008
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