MEDICARE: PREFERRED FAMILY HEALTHCARE

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	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	2445-A	TX

General Provider Information

NPI Number	:	1114050010
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PREFERRED FAMILY HEALTHCARE

Provider Business Mailing Address
First Line	:	900 E LAHARPE ST
Second Line	:
City	:	KIRKSVILLE
State	:	MO
Zip	:	63501-4520
Country	:	US
Telephone Number	:	660-665-1962
Fax Number	:	660-665-3989

Provider Business Practice Location Address
First Line	:	306 S FLORES ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78204-1106
Country	:	US
Telephone Number	:	210-224-7714
Fax Number	:	210-224-7783

Authorized Official
Title or Position	:	CEO
Name	:	MR. MICHAEL SCHWEND
Credential	:
Telephone Number	:	660-665-1962

Provider Enumeration Date	:	03/13/2007
Last Update Date	:	08/22/2020

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Directions to “PREFERRED FAMILY HEALTHCARE ” Practice Location

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