Basic Information
| Provider Information | |||||||||
| NPI: | 1710109079 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | RESPITE CARE OF SAN ANTONIO, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 605 BELKNAP PLACE | ||||||||
| Address2: | P.O. BOX 12633 | ||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107371212 | ||||||||
| FaxNumber: | 2107371221 | ||||||||
| Practice Location | |||||||||
| Address1: | 605 BELKNAP PLACE | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 78212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107371212 | ||||||||
| FaxNumber: | 2107371221 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/03/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | PFIESTER | ||||||||
| AuthorizedOfficialFirstName: | BERT | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 2107371212 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 385H00000X | Y | Respite Care Facility | Respite Care |
No ID Information.