Organization
AWAKENINGS HILL COUNTRY LLC
Active
Parent organization
AWAKENINGS HILL COUNTRY LLC
Other names
The Fullbrook Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
AWAKENINGS HILL COUNTRY LLC
Authorized official
JOSE A MIRANDA (DIRECTOR OF UR)
(210) 485-8065
Entity
Organization
Contact information
Practice address
204 JEFFERSON, KERRVILLE, TX 78028
(830) 302-2922
(830) 326-6660
Mailing address
184 FULLBROOK LN, FREDERICKSBURG, TX 78624-8313
(830) 302-2922
(830) 326-6660
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
—
—
Other
Enumeration date
11/02/2023
Last updated
05/08/2024
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