MEDICARE: WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO, 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	282E00000X	Long Term Care Hospital	100172	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	HH1088	OTHER	TX	BLUE CROSS PROVIDER #
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629037163
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WARM SPRINGS SPECIALTY HOSPITAL OF SAN ANTONIO, LLC

Provider Business Mailing Address
First Line	:	1828 GOOD HOPE RD
Second Line	:	SUITE 102
City	:	ENOLA
State	:	PA
Zip	:	17025-1233
Country	:	US
Telephone Number	:	717-731-9660
Fax Number	:	717-731-9665

Provider Business Practice Location Address
First Line	:	5418 N LOOP 1604 W
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-4558
Country	:	US
Telephone Number	:	210-600-4600
Fax Number	:	210-600-4657

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. THOMAS C. KANAVY
Credential	:
Telephone Number	:	717-731-9660

Provider Enumeration Date	:	03/22/2006
Last Update Date	:	08/03/2023

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