Healthcare Provider Details

I. General information

NPI: 1083897227
Provider Name (Legal Business Name): OAK WOOD ACRES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2007
Last Update Date: 12/11/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27340 BLANCO RD
SAN ANTONIO TX
78260-5117
US

IV. Provider business mailing address

27340 BLANCO RD
SAN ANTONIO TX
78260-5117
US

V. Phone/Fax

Practice location:
  • Phone: 830-980-2584
  • Fax: 830-980-4985
Mailing address:
  • Phone: 830-980-2584
  • Fax: 830-980-4985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number120440
License Number StateTX

VIII. Authorized Official

Name: JOSEPHINE BENAVIDES
Title or Position: OWNER
Credential:
Phone: 830-980-2584