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General NPI Number Information
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NPI Number | 1194199786
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Entity Type | Organization
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Legal Business Name | ST. MICHAEL PROVIDERS LLC
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Dates
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Enumeration Date | 11/19/2015
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Last Update Date | 02/22/2021
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Provider Practice Location Address
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Address Line | 104 PARDO CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5025
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Country | US
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Telephone | 210-960-2244
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Fax | 210-960-2240
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Provider Business Mailing Address
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Address Line | 104 PARDO CIR
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City | SAN ANTONIO
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State | TX
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Zip | 78228-5025
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Country | US
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Telephone | 210-960-2244
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Fax | 210-960-2240
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Authorized Official
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Title or Position | CEO
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Name | MS. ESTHER JADE SANMIGUEL
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Credential |
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Telephone | 210-960-2244
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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