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General NPI Number Information
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NPI Number | 1700011723
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Entity Type | Organization
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Legal Business Name | AARONS LOVING ARMS PROVIDER SERVICE
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Dates
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Enumeration Date | 05/19/2009
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Last Update Date | 03/03/2011
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Provider Practice Location Address
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Address Line | 4035 NACO PERRIN BLVD STE 210A
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2513
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Country | US
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Telephone | 210-399-1748
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Fax |
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Provider Business Mailing Address
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Address Line | 4035 NACO PERRIN BLVD STE 210 A
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City | SAN ANTONIO
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State | TX
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Zip | 78217-2530
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Country | US
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Telephone | 210-399-1748
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. DWAYNE EVERITT DANIELS SR.
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Credential |
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Telephone | 210-399-1748
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 013405
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License Number State | TX
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