Healthcare Provider Details
I. General information
NPI: 1548153083
Provider Name (Legal Business Name): STONEBRIDGE CONTINUUM OF CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/02/2025
Last Update Date: 06/02/2025
Certification Date: 06/02/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1010 CENTRAL PKWY S
SAN ANTONIO TX
78232-5021
US
IV. Provider business mailing address
1010 CENTRAL PKWY S
SAN ANTONIO TX
78232-5021
US
V. Phone/Fax
- Phone: 210-314-3476
- Fax:
- Phone: 210-314-3476
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
R
GHORMLEY
Title or Position: PRESIDENT/OWNER
Credential: PH.D
Phone: 210-314-3476