MEDICARE: ROSEMARY BERNAL

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	311ZA0620X	Adult Care Home Facility

General Provider Information

NPI Number	:	1548367725
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROSEMARY BERNAL

Provider Business Mailing Address
First Line	:	1228 RUIZ ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-1401
Country	:	US
Telephone Number	:	210-433-8519
Fax Number	:	210-433-8519

Provider Business Practice Location Address
First Line	:	1228 RUIZ ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78207-1401
Country	:	US
Telephone Number	:	210-433-8519
Fax Number	:	210-433-8519

Authorized Official
Title or Position	:	OWNER
Name	:	MS. ROSEMARY BERNAL
Credential	:
Telephone Number	:	210-433-8519

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	06/17/2008

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