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General NPI Number Information
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NPI Number | 1881954196
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Entity Type | Organization
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Legal Business Name | AIR FORCE VILLAGE II, INCORPORATED
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Dates
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Enumeration Date | 05/21/2012
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Last Update Date | 05/21/2012
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Provider Practice Location Address
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Address Line | 5200 JOHN D RYAN BLVD
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3514
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Country | US
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Telephone | 210-838-6325
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Fax |
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Provider Business Mailing Address
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Address Line | 12455 FREEDOM WAY
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City | SAN ANTONIO
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State | TX
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Zip | 78245-3526
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Country | US
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Telephone | 210-838-6325
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | BRIAN ENGLUND
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Credential | CPA
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Telephone | 210-838-6325
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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 | 130391
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License Number State | TX
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