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NPI Code Detail

MEDICARE: GOLDEN MANOR JEWISH HOME FOR THE AGED

MEDICARE: GOLDEN MANOR JEWISH HOME FOR THE AGED
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility117389TX

General Provider Information

NPI Number : 1952356370
Entity Type Code : Organization
Provider Name (Legal Business Name) : GOLDEN MANOR JEWISH HOME FOR THE AGED
Provider Business Mailing Address
First Line : 130 SPENCER LN
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2109
Country : US
Telephone Number : 210-736-4544
Fax Number : 210-732-4035
Provider Business Practice Location Address
First Line : 130 SPENCER LN
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78201-2109
Country : US
Telephone Number : 210-736-4544
Fax Number : 210-732-4035
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. SUZANNE HUBER
Credential :
Telephone Number : 210-736-4544
Provider Enumeration Date : 05/24/2006
Last Update Date : 08/22/2020

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