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General NPI Number Information
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NPI Number | 1366690430
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Entity Type | Organization
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Legal Business Name | ENDEAVOR HEALTH & WELLNESS
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Dates
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Enumeration Date | 09/03/2008
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Last Update Date | 07/08/2009
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Provider Practice Location Address
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Address Line | 19141 STONE OAK PKWY SUITE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3366
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Country | US
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Telephone | 210-832-8111
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Fax | 210-832-8117
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Provider Business Mailing Address
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Address Line | 19141 STONE OAK PKWY SUITE 104
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3366
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Country | US
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Telephone | 210-832-8111
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Fax | 210-832-8117
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | ANDREW STAFFIER
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Credential | LCSW
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Telephone | 210-832-8111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State | TX
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