Healthcare Provider Details

I. General information

NPI: 1134200785
Provider Name (Legal Business Name): INSPIRATIONS SOCIAL SERVICE AGENCY (ISSA)
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2715 WOODLINE ST
SAN ANTONIO TX
78251-2218
US

IV. Provider business mailing address

2715 WOODLINE ST
SAN ANTONIO TX
78251-2218
US

V. Phone/Fax

Practice location:
  • Phone: 210-647-4772
  • Fax: 210-647-7411
Mailing address:
  • Phone: 210-647-4772
  • Fax: 210-647-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number36742
License Number StateTX

VIII. Authorized Official

Name: MRS. MARIA A. TORRES
Title or Position: OWNER
Credential: LBSW
Phone: 210-647-4772