Organization
ELLIOTT AND GRACE LLC
Active
Other names
Selah Psychiatry
Organization subpart
No
Provider details
NPI number
Authorized official
PRECIOUS JIMBOLA CHANDLER (MEMBER)
(210) 809-4289
Entity
Organization
Contact information
Practice address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
(512) 318-2199
Mailing address
5900 BALCONES DR STE 100, AUSTIN, TX 78731-4298
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
2084P0800X
Psychiatry Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/26/2024
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