=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326462813
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RESIDENTIAL CARE HOMES OF AMERICA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2014
-----------------------------------------------------
Last Update Date | 02/05/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10410 PARRIGIN ROAD
-----------------------------------------------------
City | HELOTES
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78023-0961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 210-540-8288
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 961
-----------------------------------------------------
City | HELOTES
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78023-0961
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MANAGER
-----------------------------------------------------
Name | DANIEL KITCHEN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-540-8288
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 310400000X
-----------------------------------------------------
Taxonomy Name | Assisted Living Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------