THE FULLBROOK CENTER
NPI 1003689936
Clinic/Center - Rehabilitation, Substance Use Disorder in Kerrville, TX
NPI Status: Active since November 02, 2023
Contact Information
204 JEFFERSON
KERRVILLE, TX
ZIP 78028
Phone: (830) 302-2922
Fax: (830) 326-6660
- Organization
- Clinic/Center
- Rehabilitation, Substance Use Disorder
- Accepts Insurance
- CLIA Number: 45D2247926
- CLIA Cert. Type: Other - SUBSTANCE USE TREATMENT
- CLIA Exp. Date: 01-09-2028
About THE FULLBROOK CENTER
This page provides the complete NPI Profile along with additional information for The Fullbrook Center, a provider established in Kerrville, Texas operating as a Clinic/center, focusing in rehabilitation, substance use disorder . The healthcare provider is registered in the NPI registry with number 1003689936 assigned on November 2023. The practitioner's primary taxonomy code is 261QR0405X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The provider's is doing business as The Fullbrook Center. The authorized official of this NPI record is Jose A Miranda (Director Of Ur)
- NPI
- 1003689936
- Provider Legal Name
- AWAKENINGS HILL COUNTRY LLC
- Other Organization Name
- THE FULLBROOK CENTER
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 204 JEFFERSON KERRVILLE, TX 78028
- Location Phone
- (830) 302-2922
- Location Fax
- (830) 326-6660
- Mailing Address
- 184 FULLBROOK LN FREDERICKSBURG, TX 78624
- Mailing Phone
- (830) 302-2922
- Mailing Fax
- (830) 326-6660
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 11-02-2023
- Last Update Date
- 05-08-2024
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Clinic/Center Rehabilitation, Substance Use Disorder
- Taxonomy Code
- 261QR0405X
- Type
- Ambulatory Health Care Facilities
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Blue Advantage Bronze HMO? 204 - HMO
- Blue Advantage Bronze HMO? 301 - HMO
- Blue Advantage Bronze HMO? Standard - HMO
- Blue Advantage Gold HMO? 206 - HMO
- Blue Advantage Gold HMO? 603 - HMO
- Blue Advantage Gold HMO? Standard - HMO
- Blue Advantage Plus Bronze? 303 - POS
- Blue Advantage Plus Bronze? 305 - POS
- Blue Advantage Plus Bronze? Standard - POS
- Blue Advantage Plus Gold? 203 - POS
- Blue Advantage Plus Gold? 803 - POS
- Blue Advantage Plus Gold? Standard - POS
- Blue Advantage Plus Silver? 202 - POS
- Blue Advantage Plus Silver? 605 - POS
- Blue Advantage Plus Silver? Standard - POS
- Blue Advantage Security HMO? 200 - HMO
- Blue Advantage Silver HMO? 205 - HMO
- Blue Advantage Silver HMO? 801 - HMO
- Blue Advantage Silver HMO? Standard - HMO
- MyBlue Health Bronze? 402 - HMO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2247926
- Facility Type
- Other - SUBSTANCE USE TREATMENT
- Certificate Effective Date
- January 10, 2026
- Certificate Expiration Date
- January 09, 2028
- Laboratory Director
- CHASTITY PRICE
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to The Fullbrook Center to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1003689936, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 64 is 70. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1003689936, enumerated as an "organization" on November 02, 2023.
The provider is located at 204 JEFFERSON KERRVILLE, TX 78028 and the phone number is (830) 302-2922.
Clinic/Center with taxonomy code 261QR0405X and a focus in Rehabilitation, Substance Use Disorder.
The provider might be accepting Accepts: Blue Cross and Blue Shield of Texas. Please consult your insurance carrier or call the provider to verify.
