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Organization

ADULT PARENT FAMILY CHILD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK B HARRIS LCSW (OWNER/PROVIDER)
(210) 979-9437
Entity
Organization

Contact information

Practice address
8400 BLANCO RD, SUITE 206, SAN ANTONIO, TX 78216-3055
(210) 979-9437
(210) 979-9839
Mailing address
8400 BLANCO RD, SUITE 206, SAN ANTONIO, TX 78216-3055
(210) 979-9437
(210) 979-9839

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
25515
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00790H
BLUE CROSS BLUE SHIELD
TX
05
102864904
TX
01
4935407850000
TRICARE
TX
Enumeration date
04/30/2012
Last updated
04/30/2012
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