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RWII787520A Waterloo Counseling Center (Terminated)
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Main Details
Name
Waterloo Counseling Center
Subdivision Name
Type
Ryan White Part B
340B ID
RWII787520A
Grant Number
XO7HA00054
Additional Details
Current Program Status
Terminated
Registration Date
7/17/2018
Participating Start Date
10/1/2018
Participating Approval Date
8/27/2018
Last Recertification Date
1/28/2020
Time Period the Assistance was Received
Termination Date
Termination Reason
4/1/2021
Failure to recertify
Contacts
Authorizing Official
Waterloo Counseling Center, Inc.
Carol L Drennan, Executive Director
(512) 444-9922 Ext: 5124449922
Primary Contact
Waterloo Counseling Center, Inc.
Kellen VonHouser, Clinical Director
(512) 444-9922 Ext: 106
Addresses
Street Address
314 East Highland Mall Blvd.
Suite 301
Austin, TX 78752
Billing Address
Same as Street Address
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
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April 2025
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