MEDICARE: C&I HOLDINGS, 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	283Q00000X	Psychiatric Hospital

General Provider Information

NPI Number	:	1942546536
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C&I HOLDINGS, LLC

Provider Business Mailing Address
First Line	:	1975 BABCOCK RD
Second Line	:	SUITE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4584
Country	:	US
Telephone Number	:	210-340-0898
Fax Number	:	210-340-0901

Provider Business Practice Location Address
First Line	:	1975 BABCOCK RD
Second Line	:	SUITE 110
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4584
Country	:	US
Telephone Number	:	210-340-0898
Fax Number	:	210-340-0901

Authorized Official
Title or Position	:	MANAGER/MEMBER
Name	:	MR. NATHAN INGRAM
Credential	:
Telephone Number	:	281-914-1012

Provider Enumeration Date	:	12/31/2012
Last Update Date	:	12/31/2012

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