MEDICARE: CONTIGO INTEGRATED HOME CARE

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	253Z00000X	In Home Supportive Care Agency
2	385H00000X	Respite Care

General Provider Information

NPI Number	:	1356823678
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONTIGO INTEGRATED HOME CARE

Provider Business Mailing Address
First Line	:	2186 JACKSON KELLER RD STE 1013
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2723
Country	:	US
Telephone Number	:	210-819-4077
Fax Number	:

Provider Business Practice Location Address
First Line	:	2186 JACKSON KELLER RD STE 1013
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78213-2723
Country	:	US
Telephone Number	:	210-819-4077
Fax Number	:

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	SARAH CHINEDU CARRATALA
Credential	:
Telephone Number	:	210-819-4077

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	06/11/2019

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Directions to “CONTIGO INTEGRATED HOME CARE ” Practice Location

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