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General NPI Number Information
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NPI Number | 1538119367
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Entity Type | Organization
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Legal Business Name | BLC - PATRIOT HEIGHTS, LLC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 02/11/2015
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Provider Practice Location Address
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Address Line | 5000 FAWN MDWS
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1539
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Country | US
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Telephone | 210-696-6005
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Fax | 210-641-7881
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Provider Business Mailing Address
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Address Line | 111 WESTWOOD PL SUITE 400
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City | BRENTWOOD
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State | TN
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Zip | 37027-5021
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Country | US
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Telephone | 615-221-2250
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. MARK W OHLENDORF
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Credential |
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Telephone | 312-977-3700
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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 | 114148
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 114144
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License Number State | TX
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