DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 59
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 7ID A AND A HCS INC
CONTRACT NUMBER : 001033004 A AND A HCS INC
APPLICANT CONTACT: PEREZ MIGUEL PHONE: (469) 454-4798 FAX: (469) 454-4718
PHYSICAL ADDRESS : 721 KEESSEE DRIVE, CEDAR HILL, TX 75104-0000
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: MAVERICK 3
CONSUMERS ENROLLED STATEWIDE 21
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PROVIDER: 7IM A DIVERSE FAMILY INC.
CONTRACT NUMBER : 001033177 A DIVERSE FAMILY INC
APPLICANT CONTACT: JAI GILLARD PHONE: (210) 379-9899 FAX:
PHYSICAL ADDRESS : 1412 MAIN ST STE 2500, DALLAS, TX 75054
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 11
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PROVIDER: 7E2 A FAMILY CHOICE CDS LLC
CONTRACT NUMBER : 001030794 A FAMILY CHOICE CDS LLC
APPLICANT CONTACT: CYNTHIA SMITH PHONE: (678) 674-9996 FAX: (214) 723-7016
PHYSICAL ADDRESS : 3960 BROADWAY BLVD, STE 120, GARLAND, TX 75043
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 3
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PROVIDER: 7E4 A PRECIOUS PLACE FOR ME LLC
CONTRACT NUMBER : 001022150 A PRECIOUS PLACE FOR ME LLC
APPLICANT CONTACT: MICHAEL WILSON PHONE: (253) 310-6583 FAX: (254) 415-7218
PHYSICAL ADDRESS : 3501 VIEWCREST DR, KILLEEN, TX 76549
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8XC A TAP INC
CONTRACT NUMBER : 001009217 A TAP INC
APPLICANT CONTACT: TONY ALEXANDER PHONE: (281) 433-6529 FAX: (832) 360-2768
PHYSICAL ADDRESS : 9118 MESA DRIVE, HOUSTON, TX 77028
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 2
CONSUMERS ENROLLED STATEWIDE 51
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PROVIDER: 7CB A TEXAS HEART FOR FAMILIES INC
CONTRACT NUMBER : 001021834 A TEXAS HEART FOR FAMILIES INC
APPLICANT CONTACT: SANDRA GONZALEZ PHONE: (214) 674-9714 FAX: (469) 656-9430
PHYSICAL ADDRESS : 100 ALLENTOWN PKWY SUITE 218, ALLEN, TX 75002
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 4 MEDINA 2 VAL
VERDE 1
CONSUMERS ENROLLED STATEWIDE 130
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PROVIDER: 8Y7 A&A ADVANTAGE CARE INC
CONTRACT NUMBER : 001032350 A AND A ADVANTAGE CARE INC
APPLICANT CONTACT: DEBBIE YOUNGBLOOD PHONE: (682) 385-9133 FAX: (682) 385-9142
PHYSICAL ADDRESS : 6421 CAMP BOWIE BLVD SUITE 202, FORT WORTH, TX 76116
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 60
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 136
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PROVIDER: 8S6 AAA SPECIAL HEALTH SERVICES LLC
CONTRACT NUMBER : 001008624 AAA SPECIAL HEALTH SERVICES LLC
APPLICANT CONTACT: TAWNIE MARTIN PHONE: (210) 649-6560 FAX: (210) 520-0812
PHYSICAL ADDRESS : 6502 BANDERA RD, STE. 101, SAN ANTONIO, TX 78238
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 37 COMAL 1
CONSUMERS ENROLLED STATEWIDE 38
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PROVIDER: 79Y ABBA UNLIMITED LLC
CONTRACT NUMBER : 001021537 ABBA UNLIMITED LLC
APPLICANT CONTACT: EDWARDS JENNIFER PHONE: (512) 294-5779 FAX: (800) 359-9460
PHYSICAL ADDRESS : 1720 LOMITA DR, LEANDER, TX 78641
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: HAYS 4
CONSUMERS ENROLLED STATEWIDE 39
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PROVIDER: 815 ABILITY HOUSE, LIMITED
CONTRACT NUMBER : 001008113 ABILITY HOUSE HCS
APPLICANT CONTACT: GEORGE T. HUDSON PHONE: (210) 277-0351 FAX: (210) 384-4246
PHYSICAL ADDRESS : 4127 EAST SOUTHCROSS, SAN ANTONIO, TX 78222
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 87E ABUNDANT LIFE HCS COMPANY
CONTRACT NUMBER : 001008995 ABUNDANT LIFE HCS COMPANY
APPLICANT CONTACT: GIGI DANIELS PHONE: (469) 965-5303 FAX: (903) 765-7876
PHYSICAL ADDRESS : INDUSTRIAL RD, MT PLEASANT, TX 75455
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 152
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PROVIDER: 7CJ AC&C HCS INC
CONTRACT NUMBER : 001021860 AC & C HSC INC
APPLICANT CONTACT: JALOMO CATHERINE PHONE: (361) 779-2093 FAX: (361) 929-5946
PHYSICAL ADDRESS : 2502 SCABBARD DRIVE, CORPUS CHRISTI, TX 78414
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1 DEWITT 1 JACKSON
1 LAVACA 1
REFUGIO 1 VICTORIA 3
CONSUMERS ENROLLED STATEWIDE 26
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PROVIDER: 7HV ADELAS ANGELS LLC
CONTRACT NUMBER : 001031917 ADELAS ANGELS LLC
APPLICANT CONTACT: JOHNATHAN SEGOVIA PHONE: (830) 714-7233 FAX: (830) 714-5988
PHYSICAL ADDRESS : 2719 RUNNING FAWN, SAN ANTONIO, TX 78261-4410
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 40 MEDINA 2
CONSUMERS ENROLLED STATEWIDE 45
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DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 61
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PROVIDER: 7H2 ADVANCED LIVING OPTIONS INC
CONTRACT NUMBER : 001030878 ADVANCED LIVING OPTIONS INC
APPLICANT CONTACT: TAMMY MARTIN PHONE: (210) 551-9284 FAX: (210) 590-9503
PHYSICAL ADDRESS : 12126 WILDROSE HILL, SAN ANTONIO, TX 78230
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 1
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PROVIDER: 8NJ ADVANTAGE BEHAVIORAL SERVICES, INC.
CONTRACT NUMBER : 001008234 ADVANTAGE CARE SERVICES
APPLICANT CONTACT: TONY RITTER PHONE: (210) 641-9883 FAX: (210) 641-2863
PHYSICAL ADDRESS : 5039 BECKWITH BLVD. STE 105, SAN ANTONIO, TX 78249
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BANDERA 5 BEXAR 186
COMAL 21 GILLESPIE 35
KENDALL 6 KERR 16 KIMBLE 2 LLANO 3 MASON 2 MENARD 1
SCHLEICHER 1 SUTTON 1 UVALDE 1 VAL VERDE 3
CONSUMERS ENROLLED STATEWIDE 302
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PROVIDER: 8YM AHORA Y SIEMPRE INC
CONTRACT NUMBER : 001009389 AHORA Y SIEMPRE INC
APPLICANT CONTACT: FRANCISCO GONZALEZ PHONE: (214) 741-6359 FAX: (214) 741-6389
PHYSICAL ADDRESS : 1412 MAIN STREET STE 2500, DALLAS, TX 75202
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 2 CALHOUN 2
EDWARDS 1 JACKSON 3
KINNEY 2 LAVACA 1 LLANO 1 MAVERICK 1 SCHLEICHER 1 SUTTON 1
UVALDE 10 VAL VERDE 38 VICTORIA 1
CONSUMERS ENROLLED STATEWIDE 400
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PROVIDER: 8SM AKA HEART TO HOME LLC
CONTRACT NUMBER : 001008659 AKA HEART TO HOME LLC
APPLICANT CONTACT: LORENA MEDELLIN PHONE: (210) 499-5451 FAX: (210) 499-5457
PHYSICAL ADDRESS : 3355 CHERRY RIDGE STE 203, SAN ANTONIO, TX 78230
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 37
COMAL 1 KARNES 1
WILSON 2
CONSUMERS ENROLLED STATEWIDE 42
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PROVIDER: 8VI ALL FOR ONE SERVICES, LLC
CONTRACT NUMBER : 001008961 ALL FOR ONE SERVICES, LLC
APPLICANT CONTACT: JULIA KANTER PHONE: (512) 369-3586 FAX: (512) 904-0880
PHYSICAL ADDRESS : 8606 DANDELION TRAIL, AUSTIN, TX 78745
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 88M ALL THE LITTLE THINGS COUNT, L.C.
CONTRACT NUMBER : 001021993 ALL THE LITTLE THINGS COUNT, L.C.
APPLICANT CONTACT: CYNTHIA SCOTT PHONE: (832) 473-5453 FAX: (281) 715-4461
PHYSICAL ADDRESS : 201 FM 2917, ALVIN, TX 77511
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 289
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DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 62
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PROVIDER: 87P AMAZING GRACE HEALTHCARE SERVICES, INC.
CONTRACT NUMBER : 001007958 AMAZING GRACE HEALTHCARE SERVICES,
APPLICANT CONTACT: MICHAEL OKPAMEN PHONE: (281) 827-2081 FAX: (281) 499-0407
PHYSICAL ADDRESS : 620 FM 1092 #105, STAFFORD, TX 77477
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 2 HAYS 1
CONSUMERS ENROLLED STATEWIDE 22
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PROVIDER: 7AV AMAZING HOME COMMUNITY SERVICE
CONTRACT NUMBER : 001021614 AMAZING HOME COMMUNITY SERVICE
APPLICANT CONTACT: DANA M. GALLEGOS PHONE: (210) 598-0136 FAX: (210) 598-0052
PHYSICAL ADDRESS : 85 NE LOOP 410 STE 418, SAN ANTONIO, TX 78216
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 57
CONSUMERS ENROLLED STATEWIDE 69
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PROVIDER: 7IA AMERICAN ROSES INC
CONTRACT NUMBER : 001032872 AMERICAN ROSES INC
APPLICANT CONTACT: KENTESHA HIGH PHONE: (214) 499-8202 FAX:
PHYSICAL ADDRESS : 6634 TYREE ST, DALLAS, TX 75209
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 1
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PROVIDER: 7ED AMERITEX COMMUNITY SERVICES LL
CONTRACT NUMBER : 001032801 AMERITEX COMMUNITY SERVICES LLC
APPLICANT CONTACT: DARRY SMITH, W PHONE: (713) 970-1037 FAX: (713) 814-3979
PHYSICAL ADDRESS : 2450 LOUISIANA ST SUITE 406, HOUSTON, TX 77006
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 16
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PROVIDER: 7DC ANCHOR HABILITATION SERVICES L
CONTRACT NUMBER : 001032633 ANCHOR HABILITATION SERVICES LLC
APPLICANT CONTACT: DEBBIE FLORES PHONE: (361) 657-0247 FAX: (361) 657-0250
PHYSICAL ADDRESS : 9708 S PADRE ISLAND DR #A101, CORPUS CHRISTI, TX 78418
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 50
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PROVIDER: 7BA ANDREW M CONTRERAS III
CONTRACT NUMBER : 001021650 MIRCLES HAPPEN
APPLICANT CONTACT: ANDREW M. CONTRERAS PHONE: (210) 491-4419 FAX: (210) 490-4213
PHYSICAL ADDRESS : 2030 WINDY TRAIL, SAN ANTONIO, TX 78232
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8NH ANGEL COMMUNITY SERVICES, LLC
CONTRACT NUMBER : 001029052 ANGEL COMMUNITY SERVICES LLC
APPLICANT CONTACT: SHERRYE NAIL PHONE: (940) 456-4288 FAX: (940) 549-5263
PHYSICAL ADDRESS : 2929 HWY. 16 SOUTH, GRAHAM, TX 76450
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 63
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 87W APPROVED QUALITY CARE TEXAS,INC.
CONTRACT NUMBER : 001007873 APPROVED QUALITY CARE TEXAS,INC.
APPLICANT CONTACT: GERALD A. CHAVEZ PHONE: (512) 627-7880 FAX: (512) 280-4787
PHYSICAL ADDRESS : 1004 MEREDITH DRIVE, AUSTIN, TX 78748
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 25 COMAL 9
GILLESPIE 2 HAYS 22
KENDALL 1 KERR 3 LLANO 2
CONSUMERS ENROLLED STATEWIDE 101
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PROVIDER: 816 AUTISTIC TREATMENT CENTER INC
CONTRACT NUMBER : 001009933 AUTISTIC TREATMENT CENTER INC
APPLICANT CONTACT: ANNA HUNDLEY PHONE: (972) 644-2076 FAX: (972) 644-5650
PHYSICAL ADDRESS : 10503 METRIC DR, DALLAS, TX 75243
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 36
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PROVIDER: 7E9 AYONG HEALTHCARE LLC
CONTRACT NUMBER : 001030358 AYONG HEALTHCARE LLC
APPLICANT CONTACT: AYONG HENRIETA PHONE: (832) 417-3042 FAX:
PHYSICAL ADDRESS : 13835 WESTHOLLOW PARK DR 2805, HOUSTON, TX 77082
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 17
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PROVIDER: 8EF BELLTECH ENTERPRISES, INC.
CONTRACT NUMBER : 001007412 BELLTECH ENTERPRISES, INC.
APPLICANT CONTACT: RAFFY O. BELL PHONE: (281) 679-0541 FAX: (281) 679-0524
PHYSICAL ADDRESS : 14602 PRESIDIO SQUARE BLVD, HOUSTON, TX 77083
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: CALHOUN 2 JACKSON 1
LAVACA 1 VICTORIA 33
CONSUMERS ENROLLED STATEWIDE 66
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PROVIDER: 88G BERRY FAMILY SERVICES, INC.
CONTRACT NUMBER : 001009926 BERRY FAMILY SERVICES, INC.
APPLICANT CONTACT: CINDY BERRY PHONE: (972) 412-4707 FAX: (972) 202-0314
PHYSICAL ADDRESS : 5700 ROWLETT RD SUITE 110, ROWLETT, TX 75089
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1 HAYS 3 KERR 1
VAL VERDE 1
CONSUMERS ENROLLED STATEWIDE 1178
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PROVIDER: 78U BETTYES HEALTHCARE NETWORK INC
CONTRACT NUMBER : 001032001 BETTYES HEALTHCARE NETWORK INC
APPLICANT CONTACT: TONYA REEVES PHONE: (972) 322-2162 FAX: (817) 200-6140
PHYSICAL ADDRESS : 400 NORTH EAST STREET, ARLINGTON, TX 76011
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 98
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 64
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 050 BEXAR COUNTY BOARD OF TRUSTEES FOR MHMR SERVICES
CONTRACT NUMBER : 001007414 THE CENTER FOR HEALTH CARE SERVICES
APPLICANT CONTACT: BRAD M. BENOIT MSHCM PHONE: (210) 952-6957 FAX: (210) 659-7460
PHYSICAL ADDRESS : 8155 LONE SHADOW TRAIL, CONVERSE, TX 78109
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 190
CONSUMERS ENROLLED STATEWIDE 203
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PROVIDER: 7GP BRIGHT FUTURE HCS LLC
CONTRACT NUMBER : 001030602 BRIGHT FUTURE HCS LLC
APPLICANT CONTACT: FLORA UCHEA PHONE: (832) 531-5935 FAX: (000) 000-0000
PHYSICAL ADDRESS : 11110 JESSDALE CT, RICHMOND, TX 77407
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 38
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PROVIDER: 7FE C AND J HEALTHCARE SERVICES LL
CONTRACT NUMBER : 001033279 C & J HEALTHCARE SERVICES LLC
APPLICANT CONTACT: JUSTIN ANOWEY PHONE: (281) 996-6575 FAX: (000) 000-0000
PHYSICAL ADDRESS : 3018 HURST GREEN LANE, FRESNO, TX 77545
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 2
CONSUMERS ENROLLED STATEWIDE 2
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PROVIDER: 884 CALAB, INC.
CONTRACT NUMBER : 001007415 CALAB, INC,
APPLICANT CONTACT: AMY MCMAHAN PHONE: (210) 647-0191 FAX: (210) 647-7637
PHYSICAL ADDRESS : 6470 HEATH ROAD, SAN ANTONIO, TX 78250
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BANDERA 2 BEXAR 77
COMAL 1 KENDALL 1
MEDINA 1 WILSON 1
CONSUMERS ENROLLED STATEWIDE 258
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PROVIDER: 7FW CARE DIVINE OF GUARDIAN ANGEL
CONTRACT NUMBER : 001029839 CARE DIVINE OF GUARDIAN ANGEL LLC
APPLICANT CONTACT: IKE MARGARET PHONE: (915) 204-6727 FAX: (915) 849-7825
PHYSICAL ADDRESS : 3135 TRAWOOD DR, EL PASO, TX 79936
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 69
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PROVIDER: 76T CAROLINE CHEEVERS
CONTRACT NUMBER : 001031161 CAROLINE CHEEVERS
APPLICANT CONTACT: CAROLINE CHEEVERS PHONE: (832) 285-2995 FAX: (832) 645-3323
PHYSICAL ADDRESS : 6034 WILLOWBEND BLVD, HOUSTON, TX 77096
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: HAYS 4
CONSUMERS ENROLLED STATEWIDE 59
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PROVIDER: 7AI CAROLYN'S UNIQUE LEARNING ACTIVITY
CONTRACT NUMBER : 001029790 CAROLYN'S UNIQUE LEARNING ACTIVITY CENTE
APPLICANT CONTACT: CAROLYN JOHNSON PHONE: (214) 664-6900 FAX: (866) 302-8828
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 65
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PHYSICAL ADDRESS : 3214 OAK HILL DR, GARLAND, TX 75043
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 42
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PROVIDER: 7F5 CHOSEN COMMUNITY LIVING LLC
CONTRACT NUMBER : 001031290 CHOSEN COMMUNITY LIVING LLC
APPLICANT CONTACT: TIFFANY ROSS PHONE: (254) 415-7001 FAX: (888) 585-8513
PHYSICAL ADDRESS : 620 E. 6TH AVE, BELTON, TX 76513
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 27
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PROVIDER: 82A CHUCK C. OKEADU
CONTRACT NUMBER : 001007419 SPECIAL HOME CARE LIVING CENTER
APPLICANT CONTACT: SAMUEL A. OKEADU PHONE: (713) 771-3133 FAX: (713) 771-3113
PHYSICAL ADDRESS : 9898 BISSONNET SUITE 585, HOUSTON, TX 77036
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: COMAL 1 VICTORIA 1
CONSUMERS ENROLLED STATEWIDE 30
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PROVIDER: 7DK CITI HEALTH GROUP INC
CONTRACT NUMBER : 001022062 CITI HEALTH GROUP INC
APPLICANT CONTACT: DANIEL O. ORJI PHONE: (346) 932-7423 FAX: (832) 925-8562
PHYSICAL ADDRESS : 8449 W BELLFORT ST STE 130, HOUSTON, TX 77071
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: VICTORIA 1
CONSUMERS ENROLLED STATEWIDE 30
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PROVIDER: 86D CLETUS O OKONKWO
CONTRACT NUMBER : 001007942 ULTIMATE LIVING CENTER
APPLICANT CONTACT: SHIRLEY A. BRIGHT PHONE: (281) 540-5358 FAX: (281) 540-5356
PHYSICAL ADDRESS : 1631 TURTLEDOVE DR, CLEBURNE, TX 76033
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 89T COASTAL AREA SUPPORT ALTERNATIVES, INC.
CONTRACT NUMBER : 001008075 COASTAL AREA SUPPORT ALTERNATIVES,
APPLICANT CONTACT: AMELIA GONZALES PHONE: (361) 851-0688 FAX: (361) 851-0011
PHYSICAL ADDRESS : 5809 PATTON STREET, CORPUS CHRISTI, TX 78414
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 2
CONSUMERS ENROLLED STATEWIDE 46
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PROVIDER: 830 COMMUNITY OPTIONS, INC.
CONTRACT NUMBER : 001007421 COMMUNITY OPTIONS OF TEXAS
APPLICANT CONTACT: KELII WILLIAMS PHONE: (210) 212-4969 FAX: (512) 284-8926
PHYSICAL ADDRESS : 2632 BROADWAY SUITE 101 NORTH, SAN ANTONIO, TX 78215
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 2 BEXAR 63
COMAL 2 DIMMIT 1
HAYS 4 KARNES 2 KENDALL 1 MEDINA 3 WILSON 1 ZAVALA 1
CONSUMERS ENROLLED STATEWIDE 599
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 66
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 7IT CONNECTIDD PATHWAYS INC.
CONTRACT NUMBER : 001033287 CONNECTIDD PATHWAYS INC
APPLICANT CONTACT: KIPPES RYAN PHONE: (214) 289-4933 FAX: (000) 000-0000
PHYSICAL ADDRESS : 3322 E PARKER RD, PLANO, TX 75074-0000
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8Z6 CONNIE FOSTER OWENS
CONTRACT NUMBER : 001009434 HILL COUNTRY SIGNS OF HOPE
APPLICANT CONTACT: CONNIE F. OWENS PHONE: (903) 570-5773 FAX: (830) 895-0748
PHYSICAL ADDRESS : HARPER RD., KERRVILLE, TX 78028
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1 COMAL 1 KERR 25
CONSUMERS ENROLLED STATEWIDE 27
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PROVIDER: 8GU COUNCIL OAKS COMMUNITY OPTIONS, LTD.
CONTRACT NUMBER : 001008183 COUNCIL OAKS COMMUNITY OPTIONS, LTD
APPLICANT CONTACT: TAMMY MARTIN PHONE: (210) 646-0717 FAX: (210) 590-9503
PHYSICAL ADDRESS : 11901 TOEPPERWEIN RD STE 1001, SAN ANTONIO, TX 78233
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 25
CONSUMERS ENROLLED STATEWIDE 31
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PROVIDER: 891 D & S RESIDENTIAL SERVICES, LP
CONTRACT NUMBER : 001007422 D & S COMMUNITY SERVICES
APPLICANT CONTACT: ROBN TRAUGOTT PHONE: (210) 545-1493 FAX: (210) 545-0675
PHYSICAL ADDRESS : 3300 NACODOCHES SUITE 125, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 133 BLANCO 1 COMAL
8 DEWITT 1
FRIO 2 GILLESPIE 2 HAYS 80 KENDALL 1 KERR 1 MEDINA 2
MENARD 1 UVALDE 1 WILSON 1
CONSUMERS ENROLLED STATEWIDE 2060
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PROVIDER: 7CP DAYBREAK COMMUNITY SERVICES TEXAS
CONTRACT NUMBER : 001021877 DAYBREAK COMMUNITY SERVICES TEXAS L
APPLICANT CONTACT: ANNA TODD PHONE: (800) 299-5161 FAX: (817) 447-3033
PHYSICAL ADDRESS : 103 NORTH STAR, VICTORIA, TX 76903
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 97
CALHOUN 6 COMAL 10
DEWITT 6 GILLESPIE 1 GOLIAD 1 HAYS 4 JACKSON 5 LAVACA 7
MEDINA 1 REAL 1 REFUGIO 1 VICTORIA 64 WILSON 1
CONSUMERS ENROLLED STATEWIDE 1403
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PROVIDER: 7HE DEPENDABLE CARE SERVICES INC
CONTRACT NUMBER : 001031027 DEPENDABLE CARE SERVICES INC
APPLICANT CONTACT: TYCHELLE HILL PHONE: (210) 409-5544 FAX: (000) 000-0000
PHYSICAL ADDRESS : 4361 RITTIMAN RD, SAN ANTONIO, TX 78218
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 21
CONSUMERS ENROLLED STATEWIDE 24
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 67
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 7DV DESTINATION INDEPENDENCE LLC
CONTRACT NUMBER : 001022116 DESTINATION INDEPENDENCE LLC
APPLICANT CONTACT: DEITER SUSANNE PHONE: (210) 899-1920 FAX: (210) 444-9556
PHYSICAL ADDRESS : 103 BILTMORE ST STE 100, SAN ANTONIO, TX 78213
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 16
CONSUMERS ENROLLED STATEWIDE 23
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PROVIDER: 8XL DIVERSIFIED CARING HOMES PLLC
CONTRACT NUMBER : 001009250 DIVERSIFIED CARING HOMES PLLC
APPLICANT CONTACT: RENETTA HILLS PHONE: (832) 247-8705 FAX: (832) 582-3608
PHYSICAL ADDRESS : 16203 FLEETHAVEN LANE, HOUSTON, TX 77084
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 19
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PROVIDER: 804 EDUCARE COMMUNITY LIVING CORPORATION - TEXAS
CONTRACT NUMBER : 001007425 EDUCARE COMMUNITY LIVING CORPORATIO
APPLICANT CONTACT: WYNNE FOWLER PHONE: (210) 331-8558 FAX: (210) 979-7009
PHYSICAL ADDRESS : 3700 BELGIUM LANE, SAN ANTONIO, TX 78219
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 116
COMAL 3 HAYS 9
MEDINA 2 WILSON 3
CONSUMERS ENROLLED STATEWIDE 1252
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PROVIDER: 831 EDUCARE COMMUNITY LIVING-NORMAL LIFE INC
CONTRACT NUMBER : 001007426 EDUCARE COMMUNITY LIVING-NORMAL LIF
APPLICANT CONTACT: WYNNE FOWLER PHONE: (210) 331-8558 FAX: (210) 979-6660
PHYSICAL ADDRESS : 3700 BELGIUM LANE, SAN ANTONIO, TX 78219
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 45
CONSUMERS ENROLLED STATEWIDE 191
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PROVIDER: 8SA EMMANUEL EBEN
CONTRACT NUMBER : 001009077 REDEEM CENTER
APPLICANT CONTACT: EMMANUEL EBEN PHONE: (408) 460-7444 FAX: (956) 682-6996
PHYSICAL ADDRESS : 3020 EAGELS AVE, MCALLEN, TX 78504
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 45
CALHOUN 1 DEWITT 2
WILSON 1
CONSUMERS ENROLLED STATEWIDE 134
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PROVIDER: 7FN ENCHANTMENT LIVING HHC LLC
CONTRACT NUMBER : 001029577 ENCHANTMENT LIVING HHC LLC
APPLICANT CONTACT: CAROLYN RANDLE PHONE: (210) 273-8016 FAX:
PHYSICAL ADDRESS : GIBBS SPRAWL RD #2, SAN ANTONIO, TX 78219
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 76L EVERY MOMENT MATTERS ADMINISTRATIVE AGENCY
CONTRACT NUMBER : 001021638 EVERY MOMENT MATTERS ADMINISTRATIVE
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 68
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
APPLICANT CONTACT: EMMA WILLIAMS PHONE: (210) 214-1299 FAX: (210) 314-1576
PHYSICAL ADDRESS : MARBACH RD. SUITE 140, SAN ANTONIO, TX 78245
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 21
CONSUMERS ENROLLED STATEWIDE 33
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PROVIDER: 85M EXCEPTIONAL EMPLOYMENT SERVICES, INC.
CONTRACT NUMBER : 001008936 EXCEPTIONAL EMPLOYMENT SERVICES
APPLICANT CONTACT: KIMBERLY STEVENSON PHONE: (512) 970-9313 FAX: (512) 926-5773
PHYSICAL ADDRESS : RIDGEPOINT DRIVE #130, AUSTIN, TX 78754
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: HAYS 6
CONSUMERS ENROLLED STATEWIDE 76
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PROVIDER: 86H FLORENCE BENNETT
CONTRACT NUMBER : 001007692 DIVINITY CARE CENTER
APPLICANT CONTACT: FLORENCE BENNETT PHONE: (713) 303-1325 FAX: (281) 407-7744
PHYSICAL ADDRESS : 6111 WILCREST DRIVE, HOUSTON, TX 77072
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 7
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PROVIDER: 7EV FORCH SOLUTIONS, LLC
CONTRACT NUMBER : 001029276 FORCH SOLUTIONS, LLC
APPLICANT CONTACT: ANDREA FORCH PHONE: (713) 320-2754 FAX: (281) 990-6368
PHYSICAL ADDRESS : 9538 CHESTERFIELD LN, HOUSTON, TX 77051
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 7H6 FOREVER HOME LIVING CENTER INC
CONTRACT NUMBER : 001030875 FOREVER HOME LIVING CENTER INC
APPLICANT CONTACT: AKEEM SODE PHONE: (281) 313-0896 FAX: (281) 313-0898
PHYSICAL ADDRESS : 16710 COLD HARBOR LN, HOUSTON, TX 77083
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 10
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PROVIDER: 86V FOUR J'S COMMUNITY LIVING CENTER, INC.
CONTRACT NUMBER : 001007726 FOUR J'S COMMUNITY LIVING CENTER, I
APPLICANT CONTACT: IRMA HERNADEZ PHONE: (361) 853-7550 FAX: (361) 853-7576
PHYSICAL ADDRESS : 9207 COUNTRY CREEK DR STE 200, HOUSTON, TX 77036
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 1
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PROVIDER: 7EE GENESIS DISABILITY CARE PROVID
CONTRACT NUMBER : 001022178 GENESIS DISABILITY CARE PROVIDER IN
APPLICANT CONTACT: BAKER SHARON PHONE: (512) 905-1327 FAX: (512) 337-5644
PHYSICAL ADDRESS : 1003 VINTAGE DR, LEANDER, TX 78641
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1 GILLESPIE 1
CONSUMERS ENROLLED STATEWIDE 86
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 69
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 8RN GOOD HOME COMMUNITY LIVING INC
CONTRACT NUMBER : 001008492 GOOD HOME COMMUNITY LIVING INC
APPLICANT CONTACT: GAIL CUNNINGHAM PHONE: (210) 392-3450 FAX: (866) 298-7350
PHYSICAL ADDRESS : 2254 COUNTY ROAD 179, ALVIN, TX 77511
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 8 COMAL 3
CONSUMERS ENROLLED STATEWIDE 179
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PROVIDER: 7E3 GREAT LIFE SERVICES LLC
CONTRACT NUMBER : 001022140 GREAT LIFE SERVICES, LLC
APPLICANT CONTACT: GISELE SANTANA PHONE: (210) 656-1633 FAX: (210) 579-1314
PHYSICAL ADDRESS : 9033 AERO, STE.101, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 8 FRIO 1 MAVERICK
1 WILSON 7
CONSUMERS ENROLLED STATEWIDE 32
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PROVIDER: 7DG GUARDIAN ANGELS GROUP HOME LLC
CONTRACT NUMBER : 001022043 1 GUARDIAN ANGELS SERVICES
APPLICANT CONTACT: JOSHUA N. KARIUKI PHONE: (469) 401-7301 FAX: (972) 234-4041
PHYSICAL ADDRESS : 426 BIRCH LANE, RICHARDSON, TX 75081
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 7GR GUIDING WAY HEALTHCARE LLC
CONTRACT NUMBER : 001030600 HOUSTON SCOLIOSIS & SPINE INSTITUTE PLLC
APPLICANT CONTACT: PAMELA STEGALL PHONE: (210) 929-8394 FAX:
PHYSICAL ADDRESS : 6326 SOVEREIGN ST STE 235, SAN ANTONIO, TX 78229
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 771 HAPPY FAMILIES
CONTRACT NUMBER : 001030100 HAPPY FAMILIES
APPLICANT CONTACT: GONZALEZ ONEIDA PHONE: (956) 744-8878 FAX: (000) 000-0000
PHYSICAL ADDRESS : 220 W. HILLSIDE RD. STE 7, LAREDO, TX 78041
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 93
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PROVIDER: 82I HILL COUNTRY SAN ANTONIO MANAGEMENT INC
CONTRACT NUMBER : 001007432 HILL COUNTRY SAN ANTONIO MANAGEMENT
APPLICANT CONTACT: SANDY SMITH PHONE: (210) 710-0736 FAX: (210) 340-8302
PHYSICAL ADDRESS : 3355 CHERRY RIDGE, SUITE 108, SAN ANTONIO, TX 78230
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 79 COMAL 1
KENDALL 3 LA SALLE 1
WILSON 1
CONSUMERS ENROLLED STATEWIDE 134
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PROVIDER: 8BC HOMELIFE AND COMMUNITY SERVICES, INC.
CONTRACT NUMBER : 001007433 HOMELIFE AND COMMUNITY SERVICES, IN
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 70
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
APPLICANT CONTACT: ALYSSA SALAZAR PHONE: (210) 736-3334 FAX: (210) 736-0404
PHYSICAL ADDRESS : 2401 WILSON, SAN ANTONIO, TX 78228
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 3 BANDERA 1
BEXAR 132 DIMMIT 12
EDWARDS 1 KARNES 1 KENDALL 1 LA SALLE 1 MAVERICK 5 MEDINA
3
REAL 1 UVALDE 8 VAL VERDE 1 ZAVALA 5
CONSUMERS ENROLLED STATEWIDE 229
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PROVIDER: 77V ICARE SERVICES INC
CONTRACT NUMBER : 001032092 ICARE SERVICES INC
APPLICANT CONTACT: RUDDY ENRIQUEZ PHONE: (469) 449-9999 FAX: (469) 449-9999
PHYSICAL ADDRESS : 5103 BRADFORD DR, DALLAS, TX 75235
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 9
CONSUMERS ENROLLED STATEWIDE 40
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PROVIDER: 813 INTEGRATED COMMUNITY SERVICES, INC.
CONTRACT NUMBER : 001007435 INTEGRATED COMMUNITY SERVICES, INC.
APPLICANT CONTACT: NANCY WALL PHONE: (210) 442-7926 FAX: (210) 494-7228
PHYSICAL ADDRESS : 2391 NE LOOP 410, SUITE 110, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 15 DEWITT 1
CONSUMERS ENROLLED STATEWIDE 118
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PROVIDER: 7EJ INTEGRITY LIVING CENTER INC.
CONTRACT NUMBER : 001029198 INTEGRITY LIVING CENTER INC
APPLICANT CONTACT: DAMILOLA KING PHONE: (909) 205-5146 FAX:
PHYSICAL ADDRESS : 3102 STRATFORD POINTE DRIVE, SUGARLAND, TX 77498
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 35
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PROVIDER: 7HH JADE COMMUNITY CARE INC
CONTRACT NUMBER : 001031262 JADE COMMUNITY CARE INC
APPLICANT CONTACT: JAMES WILLIAMS PHONE: (713) 447-0726 FAX: (832) 449-3071
PHYSICAL ADDRESS : 1237 CRABB RIVER ROAD STE. C, RICHMOND, TX 77469
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1 JACKSON 1
CONSUMERS ENROLLED STATEWIDE 37
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PROVIDER: 81E JADE QUALITY CARE INC
CONTRACT NUMBER : 001008943 JADE QUALITY CARE
APPLICANT CONTACT: DEANNETTIA HOLT PHONE: (970) 840-9000 FAX: (972) 840-9045
PHYSICAL ADDRESS : 1521 NORTHWEST HWY, GARLAND, TX 75041
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 73
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PROVIDER: 77C JBP HEALTH SEVICES INC
CONTRACT NUMBER : 001029916 JBP HEALTH SEVICES INC
APPLICANT CONTACT: DOMINICS VICTORIA PHONE: (713) 505-0111 FAX: (832) 201-9697
PHYSICAL ADDRESS : 19011 GOLDEN HEATH LN, RICHMOND, TX 77407-3817
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 71
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 75M JOHNELL FERNANDEZ
CONTRACT NUMBER : 001021947 ENDLESS OPPORTUNTIES
APPLICANT CONTACT: JOHNELL FERNANDEZ PHONE: (210) 517-0070 FAX: (832) 698-9531
PHYSICAL ADDRESS : 9918 GAZELLE FOREST, SAN ANTONIO, TX 78251
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 3
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PROVIDER: 7GB KEMA CARE SERVICES INC
CONTRACT NUMBER : 001030618 KEMA CARE SERVICES INC
APPLICANT CONTACT: IKE ALARIBE PHONE: (832) 859-8777 FAX: (281) 596-4441
PHYSICAL ADDRESS : 5827 CRESTVIEW COVE, RICHMOND, TX 77469-6259
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 11
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PROVIDER: 85D KENMAR RESIDENTIAL HCS SERVICES INC
CONTRACT NUMBER : 001009682 KENMAR RESIDENTIAL HCS SERVICES INC
APPLICANT CONTACT: JO LYNN DUNN PHONE: (512) 334-9192 FAX: (512) 334-9978
PHYSICAL ADDRESS : 555 ROUND ROCK WEST SUITE F360, ROUND ROCK, TX 78681
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 256
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PROVIDER: 8Y6 KHALILAH L DOUGLAS
CONTRACT NUMBER : 001009356 JUST LIKE HOME
APPLICANT CONTACT: KHALILAH DOUGLAS PHONE: (210) 396-8472 FAX: (210) 538-5758
PHYSICAL ADDRESS : ,
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 6
CONSUMERS ENROLLED STATEWIDE 6
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PROVIDER: 7H4 KIRKLAND MINISTRIES INC
CONTRACT NUMBER : 001030862 KIRKLAND MINISTRIES INC
APPLICANT CONTACT: DELTON YORK PHONE: (210) 592-1144 FAX: (210) 855-6047
PHYSICAL ADDRESS : 7500 CALLAGHAN RD UNIT 193, SAN ANTONIO, TX 78229
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 4
CONSUMERS ENROLLED STATEWIDE 4
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PROVIDER: 7EG LASHABRIA R EVANS
CONTRACT NUMBER : 001028938 LASHABRIA R EVANS
APPLICANT CONTACT: LASHABRIA EVANS PHONE: (214) 402-6024 FAX: (972) 730-9404
PHYSICAL ADDRESS : 2825 N STATE HWY 360 APT 214, GRAND PRAIRIE, TX 75050
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 28
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PROVIDER: 87B LIFE CHOICES UNLIMITED, INC.
CONTRACT NUMBER : 001007776 LIFE CHOICES UNLIMITED, INC.
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 72
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
APPLICANT CONTACT: SERGIO CASTILLO PHONE: (888) 316-4506 FAX: (877) 316-4608
PHYSICAL ADDRESS : 85 NE LOOP 410 STE 417, SAN ANTONIO, TX 78216
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 8 COMAL 3 HAYS 1
KINNEY 1
UVALDE 1 VAL VERDE 14
CONSUMERS ENROLLED STATEWIDE 200
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PROVIDER: 8QX LIFETIME LIVING INC
CONTRACT NUMBER : 001008428 LIFETIME LIVING, INC.
APPLICANT CONTACT: DALINDA DANIELS PHONE: (210) 651-0279 FAX: (210) 651-4579
PHYSICAL ADDRESS : 5425 N LOOP 1604 E, SAN ANTONIO, TX 78247
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 8 BEXAR 245
CALHOUN 1 COMAL 32
DEWITT 1 DIMMIT 3 HAYS 2 KENDALL 2 KIMBLE 1 LAVACA 1
MAVERICK 11 MEDINA 15 REAL 2 UVALDE 17 VICTORIA 1 WILSON 2
ZAVALA 8
CONSUMERS ENROLLED STATEWIDE 794
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PROVIDER: 7I9 LIVING ANGELS HOME CARE SERVICES LLC
CONTRACT NUMBER : 001032867 LIVING ANGELS HOME CARE SERVICES LLC
APPLICANT CONTACT: WILKINS EBONNY PHONE: (210) 325-4964 FAX: (000) 000-0000
PHYSICAL ADDRESS : 1100 NW LOOP 410 STE 700, SAN ANTONIO, TX 78213
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 1
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PROVIDER: 8BG LUCKY HEALTH CARE SERVICES INC.
CONTRACT NUMBER : 001007443 LUCKY HEALTH CARE SERVICES INC.
APPLICANT CONTACT: DANIEL OSUAGWU PHONE: (713) 773-1066 FAX: (713) 773-0445
PHYSICAL ADDRESS : 10103 FONDREN SUITE 460, HOUSTON, TX 77096
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 14
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PROVIDER: 8SQ MAOFU HOME HEALTH CARE SERVICE
CONTRACT NUMBER : 001009257 MAOFU HOME HEALTH CARE SERVICES, IN
APPLICANT CONTACT: ANNE HOLLAND PHONE: (210) 753-4481 FAX: (210) 248-9070
PHYSICAL ADDRESS : 9504 N INTERSTATE 35 ST #316, SAN ANTONIO, TX 78233
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 38
CONSUMERS ENROLLED STATEWIDE 160
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PROVIDER: 8UJ MAPLES ENTERPRISES INC
CONTRACT NUMBER : 001030784 MAPLES ENTERPRISES INC
APPLICANT CONTACT: COREY MAPLES PHONE: (214) 837-0332 FAX: (866) 206-7405
PHYSICAL ADDRESS : 1021 PLACE LOUIE, DESOTO, TX 75115
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 63
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PROVIDER: 789 MARY WEDDINGTON
CONTRACT NUMBER : 001009914 MARY WEDDINGTON
APPLICANT CONTACT: MARY WEDDINGTON PHONE: (210) 773-3786 FAX: (210) 306-4223
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 73
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PHYSICAL ADDRESS : ASHLEY MEADOWS, SCHERTZ, TX 78154
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 4
CONSUMERS ENROLLED STATEWIDE 4
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PROVIDER: 8Q2 MELISSA ROXANNE ACOSTA
CONTRACT NUMBER : 001008333 MELISSA ROXANNE ACOSTA
APPLICANT CONTACT: MELISSA RO. ACOSTA PHONE: (210) 922-7227 FAX: (210) 922-7227
PHYSICAL ADDRESS : 5537 SOUTH ZARZAMORA, SAN ANTONIO, TX 78211-2044
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 12
CONSUMERS ENROLLED STATEWIDE 12
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PROVIDER: 7GX MI AMOR HOME AND COMMUNITY SERVICES LLC
CONTRACT NUMBER : 001030762 MI AMOR HOME AND COMMUNITY SERVICES LLC
APPLICANT CONTACT: FRANCISCO SAINZ PHONE: (210) 291-9112 FAX: (210) 290-9060
PHYSICAL ADDRESS : 8151 BROADWAY SUITE 109A, SAN ANTONIO, TX 78209
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8VE MILAGRO DISCOVERY HOME & COMMUNITY HEALTHCARE SERVICES INC.
CONTRACT NUMBER : 001008957 MILAGRO DISCOVERY MR COMMUNITY SERV
APPLICANT CONTACT: ANNE HOLLAND PHONE: (210) 753-4481 FAX: (210) 248-9070
PHYSICAL ADDRESS : 9504 1-35 N. ST. 316, SAN ANOTINO, TX 78233
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 11
CONSUMERS ENROLLED STATEWIDE 11
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PROVIDER: 76C MINERVA G CORONADO
CONTRACT NUMBER : 001009711 FIG TREE HOME AND COMMUNITY-BASED S
APPLICANT CONTACT: MINERVA G. CORONADO PHONE: (956) 550-0499 FAX: (956) 550-0550
PHYSICAL ADDRESS : STE B2, BROWNSVILLE, TX 78521
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 97
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PROVIDER: 887 MISSION ROAD DEVELOPMENTAL CENTER
CONTRACT NUMBER : 001007446 MISSION ROAD DEVELOPMENTAL CENTER
APPLICANT CONTACT: LORA BUTLER PHONE: (210) 924-9265 FAX: (210) 922-6006
PHYSICAL ADDRESS : 8706 MISSION ROAD, SAN ANTONIO, TX 78214
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 166
CONSUMERS ENROLLED STATEWIDE 166
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PROVIDER: 7D1 N2 CARE SERVICES INC
CONTRACT NUMBER : 001021990 NC CARE SERVICES INC
APPLICANT CONTACT: IKE ALARIBE PHONE: (832) 859-8777 FAX: (281) 239-6364
PHYSICAL ADDRESS : 5827 CRESTVIEW COVE, RICHMOND, TX 77469
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: VICTORIA 6
CONSUMERS ENROLLED STATEWIDE 12
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DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 74
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PROVIDER: 87I PASO A PASO INC.
CONTRACT NUMBER : 001007807 PASO A PASO INC.
APPLICANT CONTACT: ARNULFO GONZALEZ PHONE: (972) 572-3455 FAX: (972) 709-2519
PHYSICAL ADDRESS : 7005 PASTOR BAILEY DR STE 102B, DALLAS, TX 75237
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 4
CONSUMERS ENROLLED STATEWIDE 94
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PROVIDER: 76A PATRICIA MARIE ELIZONDO
CONTRACT NUMBER : 001009717 DOVE'S HAVEN
APPLICANT CONTACT: PATRICIA ELIZONDO PHONE: (210) 833-1297 FAX: (210) 805-0939
PHYSICAL ADDRESS : 6521 SAN PEDRO AVE, SAN ANTONIO, TX 78216
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 43 WILSON 2
CONSUMERS ENROLLED STATEWIDE 45
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PROVIDER: 8C1 PAULINE IGWE
CONTRACT NUMBER : 001007449 HUMAN SERVICES CENTER
APPLICANT CONTACT: MONICA VASQUEZ, MS PHONE: (210) 923-9100 FAX: (210) 923-9101
PHYSICAL ADDRESS : 900 SOUTH EAST MILITARY DRIVE, SAN ANTONIO, TX 78224
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 25
CONSUMERS ENROLLED STATEWIDE 146
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PROVIDER: 7GU PHOEBE ACOSTA RUIZ
CONTRACT NUMBER : 001030808 PHOEBE ACOSTA RUIZ
APPLICANT CONTACT: PHOEBE A. RUIZ PHONE: (713) 885-2667 FAX: (281) 661-1666
PHYSICAL ADDRESS : 15434 W WILLOWWIND CIR, HOUSTON, TX 77071
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 27
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PROVIDER: 808 PREMIEANT INCORPORATED
CONTRACT NUMBER : 001007450 PREMIEANT INCORPORATED
APPLICANT CONTACT: JEFF ENGELKE PHONE: (210) 525-1509 FAX: (210) 979-8047
PHYSICAL ADDRESS : 1218 ARION PARKWAY, SUITE 106, SAN ANTONIO, TX 78216
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 88
CONSUMERS ENROLLED STATEWIDE 206
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PROVIDER: 821 R & K SPECIALIZED HOMES INC
CONTRACT NUMBER : 001007452 R & K SPECIALIZED HOMES, INC.
APPLICANT CONTACT: HERNANDEZ ESEQUIEL, IV PHONE: (210) 843-4413 FAX: (210) 568-6213
PHYSICAL ADDRESS : 8802 BROADWAY, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 55
CONSUMERS ENROLLED STATEWIDE 56
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PROVIDER: 8CD REACHING MAXIMUM INDEPENDENCE INC
CONTRACT NUMBER : 001007454 REACHING MAXIMUM INDEPENDENCE
APPLICANT CONTACT: MANUEL VELA PHONE: (210) 318-5491 FAX: (210) 656-0199
PHYSICAL ADDRESS : 8242 VICAR, SAN ANTONIO, TX 78218
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 54 KENDALL 1
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 75
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
CONSUMERS ENROLLED STATEWIDE 56
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PROVIDER: 84V REGENCY COMMUNITY SERVICES INC
CONTRACT NUMBER : 001007585 REGENCY COMMUNITY SERVICES, INC.
APPLICANT CONTACT: SHANE WEST PHONE: (210) 403-9372 FAX: (210) 495-1538
PHYSICAL ADDRESS : 2391 N.E. LOOP 410, SUITE 403, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 42 COMAL 2
CONSUMERS ENROLLED STATEWIDE 44
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PROVIDER: 8YH ROBERT S MORRIS
CONTRACT NUMBER : 001031757 ROBERT S MORRIS
APPLICANT CONTACT: LETICIA PEREZ PHONE: (512) 239-8501 FAX:
PHYSICAL ADDRESS : STE E203, ROUND ROCK, TX 78681
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: HAYS 1 WILSON 2
CONSUMERS ENROLLED STATEWIDE 73
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PROVIDER: 7E6 SAMLIZY HCS AND TXHML SERVICE
CONTRACT NUMBER : 001029239 SAMLIZY HCS AND TXHML SERVICES INC
APPLICANT CONTACT: CHINONSO ADIMIBE PHONE: (832) 620-7018 FAX: (832) 620-7018
PHYSICAL ADDRESS : 10022 HALSTON DR, SUGARLAND, TX 77498-2781
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8PR SEGNIK GROUP INC
CONTRACT NUMBER : 001032546 SEGNIK GROUP INC
APPLICANT CONTACT: JOSHUA OYENIYI PHONE: (713) 484-8699 FAX: (713) 484-8675
PHYSICAL ADDRESS : 7001 CORPORATE DR STE 302, HOUSTON, TX 77036
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 402
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PROVIDER: 8UY SETH MOYER SUPPORT MICROBOARD
CONTRACT NUMBER : 001008904 SETH MOYER SUPPORT MICROBOARD
APPLICANT CONTACT: MARTHA MOYER PHONE: (210) 635-8339 FAX: (210) 635-8339
PHYSICAL ADDRESS : 7665 FM 327, ELMENDORF, TX 78112-9808
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 7DB SHAREL SULLIVAN
CONTRACT NUMBER : 001022083 THE HARMONY PLACE HOME
APPLICANT CONTACT: SULLIVAN SHAREL PHONE: (972) 670-0559 FAX: (972) 287-4204
PHYSICAL ADDRESS : 612 W. MAIN ST. SUITE 102, LEAGUE CITY, TX 75150
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 45
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PROVIDER: 7IY SHELTER COMMUNITY SERVICES INC
CONTRACT NUMBER : 001033411 SHELTER COMMUNITY SERVICES INC
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 76
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
APPLICANT CONTACT: MINI PRINCE PHONE: (469) 778-0051 FAX: (469) 778-0071
PHYSICAL ADDRESS : 8111 LBJ FREEWAY SUITE 1225, DALLAS, TX 75251
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 7H3 SHERRIE ANDERSON
CONTRACT NUMBER : 001030846 SHERRIE ANDERSON
APPLICANT CONTACT: SHERRIE ANDERSON PHONE: (469) 396-2532 FAX: (214) 594-7649
PHYSICAL ADDRESS : 827 BENTLE ST, CEDAR HILL, TX 75104
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 8XU SHINE ON GROUP HOMES LLC
CONTRACT NUMBER : 001009291 SHINE ON GROUP HOMES, LLC
APPLICANT CONTACT: SHEILA J. KOEPPEN, MS PHONE: (830) 237-9692 FAX: (210) 595-7473
PHYSICAL ADDRESS : LAS NUBES, SAN ANTONIO, TX 78233
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 26
CONSUMERS ENROLLED STATEWIDE 26
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PROVIDER: 8MW STELLA OBI
CONTRACT NUMBER : 001008136 STELLA OBI
APPLICANT CONTACT: STELLA OBI PHONE: (210) 530-4662 FAX: (210) 530-4665
PHYSICAL ADDRESS : 5626 GINGER RISE, SAN ANTONIO, TX 78253
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 11
CONSUMERS ENROLLED STATEWIDE 12
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PROVIDER: 7DA STEPHENS COMMUNITY LIVING HCS
CONTRACT NUMBER : 001022107 STEPHENS COMMUNITY LIVING HCS
APPLICANT CONTACT: FELICIA NASH PHONE: (469) 274-2828 FAX: (469) 453-3379
PHYSICAL ADDRESS : 1411 EAST CAMPBELL RD STE400, RICHARDSON, TX 75081
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 8
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PROVIDER: 7CX TAB INTERNATIONAL INC
CONTRACT NUMBER : 001021974 TAB INTERNATIONAL INC
APPLICANT CONTACT: BALOGUN ABAYOMI PHONE: (713) 772-2726 FAX: (713) 981-1990
PHYSICAL ADDRESS : 10101 FONDREN ROAD STE 428, HOUSTON, TX 77096
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
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PROVIDER: 825 TEXAS HCS, INC.
CONTRACT NUMBER : 001007460 TEXAS HCS INC.
APPLICANT CONTACT: NANCY WALL PHONE: (210) 494-1030 FAX: (210) 494-7228
PHYSICAL ADDRESS : 2391 NE LOOP 410, SUITE 110, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 18 FRIO 1
CONSUMERS ENROLLED STATEWIDE 109
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 77
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
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PROVIDER: 7EU TOTAL FRIENDLY CARE INC
CONTRACT NUMBER : 001029448 TOTAL FRIENDLY CARE INC
APPLICANT CONTACT: JULIE OBI PHONE: (832) 767-3605 FAX: (832) 767-3626
PHYSICAL ADDRESS : 6776 SOUTHWEST FREEWAY STE 630, HOUSTON, TX 77074
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 14
CONSUMERS ENROLLED STATEWIDE 32
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PROVIDER: 7C1 TRIED AND TRUE HOME CARE SERVICES,LLC
CONTRACT NUMBER : 001021769 TRIED AND TRUE HOME CARE SERVICES,L
APPLICANT CONTACT: TANISHA FULLER FELIX PHONE: (210) 305-4961 FAX:
PHYSICAL ADDRESS : 5253 WALZEM RD UNIT 3, SAN ANTONIO, TX 78218
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 11
CONSUMERS ENROLLED STATEWIDE 11
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PROVIDER: 8NW UNIOS, INC.
CONTRACT NUMBER : 001008290 UNIOS, INC.
APPLICANT CONTACT: MARY K. MORALES PHONE: (210) 293-0193 FAX: (210) 293-0194
PHYSICAL ADDRESS : 51 COUNTY ROAD 150, SAN ANTONIO, TX 78223
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 4 BEXAR 10
KARNES 3 WILSON 16
CONSUMERS ENROLLED STATEWIDE 33
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PROVIDER: 7GH VIRTUES OF LOVE PLACE LLC
CONTRACT NUMBER : 001030329 VIRTUES OF LOVE PLACE LLC
APPLICANT CONTACT: AGATHA SHIPMAN PHONE: (301) 213-6728 FAX:
PHYSICAL ADDRESS : 1003 OAKRIDGE ST, BRENHAM, TX 77833
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 3
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PROVIDER: 828 VOLUNTEERS OF AMERICA TEXAS INC
CONTRACT NUMBER : 001007467 VOLUNTEERS OF AMERICA TEXAS, INC.
APPLICANT CONTACT: LINDA VACHON PHONE: (817) 235-1606 FAX: (817) 529-2116
PHYSICAL ADDRESS : 300 E MIDWAY DRIVE, EULESS, TX 76039
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 170
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PROVIDER: 89K WELLNESS HEALTHCARE SOLUTIONS, INC.
CONTRACT NUMBER : 001032214 WELLNESS HEALTHCARE SOLUTIONS INC
APPLICANT CONTACT: CATHERINE MALONE PHONE: (469) 567-2100 FAX: (469) 587-8707
PHYSICAL ADDRESS : 1801 N HAMPTON ROAD SUITE 240, DESOTO, TX 75115
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: BEXAR 1
CONSUMERS ENROLLED STATEWIDE 345
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PROVIDER: 8D4 YES, I CAN, INC.
CONTRACT NUMBER : 001007468 YES, I CAN, INC.
APPLICANT CONTACT: MONICA GONZALEZ PHONE: (210) 599-6668 FAX: (210) 599-6737
DATE PREPARED: 04-27-24 H H S C REPORT NO.: HC062096
TIME PREPARED: 01:49 HCS PROGRAM PROVIDER INFORMATION PAGE
: 78
WAIVER CONTRACT AREA: 7
MRA: 051 ALAMO AREA COUNCIL OF GOV'T
PHYSICAL ADDRESS : 10807 PERRIN BEITEL RD STE 100, SAN ANTONIO, TX 78217
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: ATASCOSA 1 BEXAR 74
CONSUMERS ENROLLED STATEWIDE 77
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PROVIDER: 7IW 1DERFULL MINDS, INC.
CONTRACT NUMBER : 001033396 1DERFULL MINDS INC
APPLICANT CONTACT: J RANDY ROUTON PHONE: (469) 235-2390 FAX: (972) 637-7576
PHYSICAL ADDRESS : 631 CRESENT DRIVE, DE SOTO, TX 75115
CONSUMERS ENROLLED IN THE FOLLOWING COUNTIES: NONE
CONSUMERS ENROLLED STATEWIDE 0
TOTAL NUMBER OF CONTRACTS THIS MRA: 124
