Organization Name: | MISSION ROAD DEVELOPMENTAL CENTER |
NPI Number: | 1538532429 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LORA S. BUTLER (EXECUTIVE DIRECTOR) |
Mailing Address: | 8706 Mission Rd San Antonio |
State: | TX US |
Postal Code: | 782143140 |
Phone Number: | 2109249265 |
Fax Number: | 2109226006 |
NPI Enumeration Date: | 11/02/2015 |
NPI Last Update Date: | 11/23/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 123357 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |