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General NPI Number Information
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NPI Number | 1639225428
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Entity Type | Organization
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Legal Business Name | SRRLLC
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Dates
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Enumeration Date | 01/26/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1796 BI 35 E
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City | PEARSALL
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State | TX
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Zip | 78061
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Country | US
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Telephone | 830-334-9390
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Fax | 830-334-9423
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Provider Business Mailing Address
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Address Line | P.O. BOX 1145 1796 B1 35 E
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City | PEARSALL
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State | TX
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Zip | 78061
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Country | US
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Telephone | 830-334-9390
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Fax | 830-334-9423
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | ALMA S MALDONADO
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Credential |
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Telephone | 830-334-9390
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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