OrganizationActive
Mip Sa LLC
NPI 1568265205 · Adolescent and Children Mental Health Clinic/Center · San Antonio, TX
Provider details
- NPI number
- 1568265205
- Entity type
- Organization
- Primary specialty
- Adolescent and Children Mental Health Clinic/CenterAmbulatory Health Care Facilities
- Parent organization
- Mip Svc LLC
- Organization subpart
- Yes
- Authorized official
- Dina Kushaliyeva, Director(214) 802-0224
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
901 Ne Loop 410 # 405
San Antonio, TX 78209-1305
Phone: (210) 926-5502
Approximate (ZIP-level) locationGet directions
Mailing address
901 Ne Loop 410 # 405
San Antonio, TX 78209-1305
Registry dates
- Enumerated
- 2025-03-28
- Last updated
- 2025-09-11
- Certified
- 2025-03-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.