Healthcare Provider Details

I. General information

NPI: 1942347026
Provider Name (Legal Business Name): LOPEZ ASSISTED LIVING HOMES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 06/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3706 SHERRIL BROOK RD
SAN ANTONIO TX
78228-3857
US

IV. Provider business mailing address

3706 SHERRIL BROOK RD
SAN ANTONIO TX
78228-3857
US

V. Phone/Fax

Practice location:
  • Phone: 210-884-4697
  • Fax: 210-436-9106
Mailing address:
  • Phone: 210-884-4697
  • Fax: 210-436-9106

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number100358
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number030366
License Number StateTX

VIII. Authorized Official

Name: RYAN WHITNEY MLCAK
Title or Position: DIRECTOR
Credential:
Phone: 210-884-4697