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General NPI Number Information
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NPI Number | 1033527650
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Entity Type | Organization
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Legal Business Name | ONCE UPON A TIME HOME HEALTH, LLC
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Dates
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Enumeration Date | 07/28/2014
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Last Update Date | 06/12/2015
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Provider Practice Location Address
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Address Line | 4027 PARKWAY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-2312
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Country | US
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Telephone | 210-432-6623
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Fax | 210-432-2663
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Provider Business Mailing Address
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Address Line | 4027 PARKWAY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-2312
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Country | US
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Telephone | 210-432-6623
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TOMAS ALONZO
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Credential |
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Telephone | 210-432-6623
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 123456
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 123456
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License Number State | TX
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