MEDICARE: SUNRISE HOME HEALTH SERVICES OF SAN ANTONIO, 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	251E00000X	Home Health Agency	007066	TX

General Provider Information

NPI Number	:	1750315461
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNRISE HOME HEALTH SERVICES OF SAN ANTONIO, INC.

Provider Business Mailing Address
First Line	:	1825 W OLMOS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-4016
Country	:	US
Telephone Number	:	210-735-0606
Fax Number	:	210-732-7370

Provider Business Practice Location Address
First Line	:	1825 W OLMOS DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78201-4016
Country	:	US
Telephone Number	:	210-735-0606
Fax Number	:	210-732-7370

Authorized Official
Title or Position	:	CEO - PRESIDENT
Name	:	MS. ELIZABETH LEAL
Credential	:
Telephone Number	:	210-735-0606

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	03/19/2012

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