Organization
MOLDEN TO WIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRELL JACKSON PASTOR (PROGRAM DIRECTOR)
(210) 782-4321
Entity
Organization
Contact information
Practice address
10027 BERMUDA PALM, SAN ANTONIO, TX 78245-2892
(210) 782-4321
Mailing address
10027 BERMUDA PALM, SAN ANTONIO, TX 78245-2892
(210) 782-4321
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
TX
251S00000X
Community/Behavioral Health Agency
—
TX
253J00000X
Foster Care Agency
253J00000X
TX
Other
Enumeration date
02/27/2017
Last updated
02/27/2017
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