MEDICARE: ENDEAVORS UNLIMITED

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	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1902585631
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ENDEAVORS UNLIMITED

Provider Business Mailing Address
First Line	:	6363 DE ZAVALA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2103
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6363 DE ZAVALA RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-2103
Country	:	US
Telephone Number	:	210-523-0377
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	ELIQUE GUERRA
Credential	:
Telephone Number	:	210-523-0377

Provider Enumeration Date	:	07/11/2023
Last Update Date	:	12/12/2024

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