Healthcare Provider Details

I. General information

NPI: 1417353145
Provider Name (Legal Business Name): UALC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 HAM LN
UVALDE TX
78801-6256
US

IV. Provider business mailing address

201 HAM LN
UVALDE TX
78801-6256
US

V. Phone/Fax

Practice location:
  • Phone: 830-278-8220
  • Fax:
Mailing address:
  • Phone: 830-278-8220
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: LOREE TAMAYO
Title or Position: CEO MANAGMENT COMPANY
Credential:
Phone: 210-326-6662