MEDICARE: JUBILEE ACADEMIC CENTER, 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	251300000X	Local Education Agency (LEA)

General Provider Information

NPI Number	:	1285920827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JUBILEE ACADEMIC CENTER, INC.

Provider Business Mailing Address
First Line	:	7330 SAN PEDRO AVE
Second Line	:	SUITE 670
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-6235
Country	:	US
Telephone Number	:	210-447-9101
Fax Number	:

Provider Business Practice Location Address
First Line	:	4434 ROLAND RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78222-2830
Country	:	US
Telephone Number	:	210-333-6227
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	DEBBIE CONSTABLE
Credential	:
Telephone Number	:	210-447-9101

Provider Enumeration Date	:	06/22/2011
Last Update Date	:	06/22/2011

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