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MARY LEE FOUNDATION NPI 1063614022


NPI Information

NPI: 1063614022
Provider Name: MARY LEE FOUNDATION
Classification: Community/Behavioral Health - 251S00000X
Entity Type: Organization
Address:
1336 LAMAR SQUARE DR
SUITE A
AUSTIN, TX
ZIP 78704
Phone: (512) 442-6077
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MARY LEE FOUNDATION is a community behavioral health in Austin, TX. The provider is a private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, intellectual disabilities, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. MARY LEE FOUNDATION NPI is 1063614022. The provider is registered as an organization entity type.

The provider's business location address is:

1336 LAMAR SQUARE DR
SUITE A
AUSTIN, TX
ZIP 78704-214
Phone: (512) 442-6077
Fax: (512) 442-6825

The provider's authorized official is Don Lilljedahl .
The authorized official title is Director Of Founation and has the following contact phone number (512) 443-5777.

The enumeration date for this NPI number is 6/1/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1251S00000XCommunity/Behavioral Health115796TEXASNo
2251S00000XCommunity/Behavioral Health114956TEXASNo
3251S00000XCommunity/Behavioral Health115787TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
123346482 993OTHERTEXASPRS CONTRACT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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