Healthcare Provider Details

I. General information

NPI: 1295251098
Provider Name (Legal Business Name): LITTLE ENGINE HOMECARE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3201 CHERRY RIDGE ST STE D400
SAN ANTONIO TX
78230-4820
US

IV. Provider business mailing address

3201 CHERRY RIDGE ST STE D400
SAN ANTONIO TX
78230-4820
US

V. Phone/Fax

Practice location:
  • Phone: 210-692-0222
  • Fax:
Mailing address:
  • Phone: 210-692-0222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number111792
License Number StateTX

VIII. Authorized Official

Name: MS. ASCHWIN POL
Title or Position: DIRECTOR OF OPERATIONS
Credential:
Phone: 210-692-0222