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General NPI Number Information
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NPI Number | 1093602336
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Entity Type | Organization
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Legal Business Name | RISING STAR COMMUNITY HOUSING LLC
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Dates
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Enumeration Date | 06/19/2025
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 111 SOLEDAD ST STE 470
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2243
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Country | US
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Telephone | 210-992-6801
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Fax |
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Provider Business Mailing Address
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Address Line | 819 MCDOUGAL AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78223-1645
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Country | US
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Telephone | 210-992-6801
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Fax |
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Authorized Official
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Title or Position | PROGRAM DIRECTOR
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Name | JUDITH GARZA
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Credential | RN
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Telephone | 210-992-6801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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