Organization
AUSTIN CHILD GUIDANCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSANNE MATTHEWS (ADMIN. DIRECTOR)
(512) 451-2242
Entity
Organization
Contact information
Practice address
810 W 45TH ST, AUSTIN, TX 78751-2802
(512) 451-2242
(512) 454-9204
Mailing address
810 W 45TH ST, AUSTIN, TX 78751-2802
(512) 451-2242
(512) 454-9204
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01043JC
BLUE CROSS BLUE SHEILD
TX
Enumeration date
01/04/2007
Last updated
07/03/2012
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