Healthcare Provider Details

I. General information

NPI: 1396766382
Provider Name (Legal Business Name): RIVER CITY CARE CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 06/01/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 NOLAN
SAN ANTONIO TX
78202-2323
US

IV. Provider business mailing address

921 NOLAN
SAN ANTONIO TX
78202-2323
US

V. Phone/Fax

Practice location:
  • Phone: 210-226-6397
  • Fax: 210-226-8074
Mailing address:
  • Phone: 210-226-6397
  • Fax: 210-226-8074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number314000000X
License Number StateTX

VIII. Authorized Official

Name: MR. SHAWN LEON CONLEY
Title or Position: CFO
Credential: CFO
Phone: 817-303-4089