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General NPI Number Information
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NPI Number | 1396073474
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Entity Type | Organization
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Legal Business Name | RJ MERIDIAN CARE ALTA VISTA LLC
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Dates
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Enumeration Date | 11/30/2009
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Last Update Date | 05/03/2023
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Provider Practice Location Address
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Address Line | 616 W RUSSELL PL
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City | SAN ANTONIO
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State | TX
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Zip | 78212-3658
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Country | US
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Telephone | 281-465-0636
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Fax | 281-465-0748
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Provider Business Mailing Address
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Address Line | 25009 OAKHURST DR
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City | SPRING
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State | TX
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Zip | 77386-1975
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Country | US
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Telephone | 281-465-0636
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Fax | 281-465-0748
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | MR. RAMIRO G LOZANO
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Credential |
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Telephone | 281-465-0636
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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