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General NPI Number Information
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NPI Number | 1770197287
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Entity Type | Organization
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Legal Business Name | INCARNATE WORD RETIREMENT COMMUNITY, INC.
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Dates
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Enumeration Date | 09/02/2020
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Last Update Date | 09/02/2020
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Provider Practice Location Address
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Address Line | 4707 BROADWAY
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City | SAN ANTONIO
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State | TX
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Zip | 78209-6215
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Country | US
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Telephone | 210-829-7561
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Fax | 210-828-0020
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Provider Business Mailing Address
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Address Line | 17621 STATE HIGHWAY 95
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City | HOLLAND
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State | TX
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Zip | 76534-4422
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Country | US
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Telephone | 512-868-7567
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Fax |
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Authorized Official
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Title or Position | VP OF FINANCE AND CFO
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Name | JOAN DIXON
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Credential |
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Telephone | 210-829-7561
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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