Organization
LIFESTEPS COUNCIL FOR ALCOHOL & DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LISA WALLACE LCDC, LMSW (PROGRAM DIRECTOR, PPI/PADRE)
(512) 869-2571
Entity
Organization
Contact information
Practice address
311 S MAIN ST, GEORGETOWN, TX 78626-5048
(512) 869-2571
(512) 869-1667
Mailing address
PO BOX 1279, GEORGETOWN, TX 78627-1279
(512) 869-2571
(512) 246-9880
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2766232152
CMBHS
TX
Enumeration date
07/19/2018
Last updated
07/19/2018
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