Organization
EXPOSURE EXPLOSION FESTIVAL
Active
Other names
Exposure Explosion Hybrid Mental Health Wellness Center, Exposure Explosion Hybrid Wellness Center, Exposure Explosion Hybrid Mental Health Center, Exposure Explosion Hybrid Urgent Care
Organization subpart
No
Provider details
NPI number
Authorized official
DYNASTY HOLLAND (OWNER)
(210) 238-4427
Entity
Organization
Contact information
Practice address
12330 VANCE JACKSON RD APT 4201, SAN ANTONIO, TX 78230-6009
(210) 238-4427
Mailing address
907 PEGGOTTY PL, AUSTIN, TX 78753-6932
(210) 238-4427
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TE1100X
Exercise & Sports Psychologist
—
—
174200000X
Meals Provider
—
—
251K00000X
Public Health or Welfare Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
251V00000X
Voluntary or Charitable Agency
—
—
261QC1800X
Corporate Health Clinic/Center
—
—
261QE0002X
Emergency Care Clinic/Center
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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