Basic Information
| Provider Information | |||||||||
| NPI: | 1578604203 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOURNEY HOSPICE OF SAN ANTONIO, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5828 SEBASTIAN PL | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782492229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105589606 | ||||||||
| FaxNumber: | 2105586934 | ||||||||
| Practice Location | |||||||||
| Address1: | 5828 SEBASTIAN PL | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782492229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105589606 | ||||||||
| FaxNumber: | 2105586934 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/08/2007 | ||||||||
| LastUpdateDate: | 08/19/2010 | ||||||||
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| AuthorizedOfficialLastName: | MARTINDALE | ||||||||
| AuthorizedOfficialFirstName: | PHYLLIS | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9019373030 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251G00000X | Y | Agencies | Hospice Care, Community Based |
No ID Information.