| Organization Name: | JOURNEY HOSPICE OF SAN ANTONIO, LLC |
| NPI Number: | 1578604203 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PHYLLIS MARTINDALE (BILLING MANAGER) |
| Mailing Address: | 5828 Sebastian Pl San Antonio |
| State: | TX US |
| Postal Code: | 782492229 |
| Phone Number: | 2105589606 |
| Fax Number: | 2105586934 |
| NPI Enumeration Date: | 02/08/2007 |
| NPI Last Update Date: | 08/19/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 251G00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Agencies |
| Taxonomy Classification: | Hospice Care, Community Based |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |