Healthcare Provider Details
I. General information
NPI: 1346002938
Provider Name (Legal Business Name): INSPIRED SENIOR LIVING OF SAN MARCOS MT LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2024
Last Update Date: 01/29/2024
Certification Date: 01/29/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
802 LEAH AVE
SAN MARCOS TX
78666-7951
US
IV. Provider business mailing address
7047 E GREENWAY PKWY STE 300
SCOTTSDALE AZ
85254-8116
US
V. Phone/Fax
- Phone: 737-373-2456
- Fax:
- Phone: 480-748-4339
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 310400000X |
| Taxonomy | Assisted Living Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
LUKE
LEE
Title or Position: MANAGER
Credential:
Phone: 480-748-4339