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General NPI Number Information
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NPI Number | 1457593089
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Entity Type | Organization
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Legal Business Name | CARDINAL SENIOR CARE LLC
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Dates
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Enumeration Date | 03/27/2009
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Last Update Date | 08/15/2022
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Provider Practice Location Address
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Address Line | 4402 VANCE JACKSON RD STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5334
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Country | US
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Telephone | 210-684-7080
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Fax | 866-702-1663
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Provider Business Mailing Address
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Address Line | 4402 VANCE JACKSON RD STE 202
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City | SAN ANTONIO
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State | TX
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Zip | 78230-5334
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Country | US
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Telephone | 210-323-9187
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Fax | 866-702-1663
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | HAMID MANGALJI
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Credential |
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Telephone | 210-323-9187
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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