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General NPI Number Information
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NPI Number | 1457531253
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Entity Type | Organization
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Legal Business Name | BRANDON HOUSE CONSULTING
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Dates
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Enumeration Date | 11/08/2007
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Last Update Date | 12/03/2008
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Provider Practice Location Address
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Address Line | 231 G ST
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City | SAN ANTONIO
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State | TX
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Zip | 78210-2622
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Country | US
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Telephone | 210-858-8773
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Fax | 210-858-6264
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Provider Business Mailing Address
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Address Line | 231 G ST
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City | SAN ANTONIO
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State | TX
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Zip | 78210-2622
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Country | US
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Telephone | 210-858-8773
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Fax | 210-858-6264
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Authorized Official
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Title or Position | OWNER/CEO/DIRECTOR
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Name | MS. MASSIE LEE WILSON
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Credential | M.ED
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Telephone | 210-858-8773
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 120980
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License Number State | TX
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