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Organization

OPTIMUM RESIDENTIAL SERVICES LTD.

Active
Other names
Brantley Cove
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MIKE HAWKER (CFO)
(512) 892-2191
Entity
Organization

Contact information

Practice address
2579 WESTERN TRAILS BLVD, AUSTIN, TX 78745-1578
(512) 892-2191
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 340-7155

Taxonomy

Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
007210
TX

Other

Enumeration date
04/20/2006
Last updated
08/22/2020
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