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General NPI Number Information
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NPI Number | 1114464351
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Entity Type | Organization
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Legal Business Name | ALPHA OMEGA SA1 HEALTHCARE
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Dates
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Enumeration Date | 01/26/2017
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Last Update Date | 01/26/2017
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Provider Practice Location Address
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Address Line | 1506 AGENCY POINT
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City | SAN ANTONIO
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State | TX
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Zip | 78245
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Country | US
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Telephone | 832-929-0662
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Fax | 210-451-7493
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Provider Business Mailing Address
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Address Line | 1506 AGENCY PT
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City | SAN ANTONIO
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State | TX
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Zip | 78245-2924
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Country | US
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Telephone | 832-929-0662
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Fax | 210-451-7493
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Authorized Official
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Title or Position | DIRECTOR
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Name | CHANELL T DANIELS
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Credential |
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Telephone | 832-929-0662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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