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General NPI Number Information
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NPI Number | 1831376607
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Entity Type | Organization
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Legal Business Name | IHCS RESIDENTIAL, INC.
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Dates
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Enumeration Date | 01/23/2008
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Last Update Date | 09/05/2019
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Provider Practice Location Address
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Address Line | 15218 PEBBLE FOREST
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City | SAN ANTONIO
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State | TX
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Zip | 78232
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Country | US
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Telephone | 210-888-0127
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Fax | 866-343-7703
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Provider Business Mailing Address
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Address Line | 2935 THOUSAND OAKS, #6, SUITE #170
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City | SAN ANTONIO
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State | TX
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Zip | 78247-3653
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Country | US
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Telephone | 909-399-9195
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Fax |
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. GAYLE MARIE WASHINGTON'YATES
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Credential |
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Telephone | 210-888-0127
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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 |
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License Number State |
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