MEDICARE: JUNCTION LONG TERM CARE, LLC

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	314000000X	Skilled Nursing Facility	004838	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	:	1194969782
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUNCTION LONG TERM CARE, LLC

Provider Business Mailing Address
First Line	:	526 TEXAS PT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78260-7738
Country	:	US
Telephone Number	:	210-316-7790
Fax Number	:	210-497-2497

Provider Business Practice Location Address
First Line	:	111 HOSPITAL DR
Second Line	:
City	:	JUNCTION
State	:	TX
Zip	:	76849-3020
Country	:	US
Telephone Number	:	210-316-7790
Fax Number	:	210-497-2497

Authorized Official
Title or Position	:	PRESIDENT/MANAGER
Name	:	MR. DAVID LAIN BYERS
Credential	:
Telephone Number	:	210-316-7790

Provider Enumeration Date	:	04/27/2009
Last Update Date	:	04/27/2009

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Directions to “JUNCTION LONG TERM CARE, LLC ” Practice Location

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