MEDICARE: HALL MANAGEMENT GROUP, 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	261QA0600X	Adult Day Care Clinic/Center	118018	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134200439
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HALL MANAGEMENT GROUP, INC.

Provider Business Mailing Address
First Line	:	2040 BABCOCK RD STE 300
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4428
Country	:	US
Telephone Number	:	210-692-3003
Fax Number	:	210-692-3004

Provider Business Practice Location Address
First Line	:	2827 HILLCREST DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-7047
Country	:	US
Telephone Number	:	210-734-2580
Fax Number	:	210-731-4151

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES CLIFTON HALL
Credential	:
Telephone Number	:	210-692-3003

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	07/18/2008

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