MEDICARE: RIOS BOARD & CARE SERVICE INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	010230	TX

General Provider Information

NPI Number	:	1083851067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIOS BOARD & CARE SERVICE INC

Provider Business Mailing Address
First Line	:	1618 S SAINT MARYS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78210-1634
Country	:	US
Telephone Number	:	210-532-7698
Fax Number	:

Provider Business Practice Location Address
First Line	:	1618 S SAINT MARYS
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78210-1634
Country	:	US
Telephone Number	:	210-532-7698
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. LUCY RIOS
Credential	:
Telephone Number	:	210-521-8776

Provider Enumeration Date	:	01/13/2009
Last Update Date	:	01/13/2009

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