Organization Name: | ALTUS HOSPICE OF SAN ANTONIO |
NPI Number: | 1629467865 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARK MULLINAX (SENIOR VP OPERATIONS) |
Mailing Address: | 2700 Ne Loop 410 Ste 695 San Antonio |
State: | TX US |
Postal Code: | 782174894 |
Phone Number: | 2109202620 |
Fax Number: | 2109202630 |
NPI Enumeration Date: | 01/12/2015 |
NPI Last Update Date: | 07/07/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 251G00000X |
License Number: | 016863 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Agencies |
Taxonomy Classification: | Hospice Care, Community Based |
Taxonomy Specialization: | |
Taxonomy Definition: |