Organization Name: | BLUE RIVER HEALTH SYSTEM, LLC |
NPI Number: | 1780096685 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MIGUEL A. VELEZ (ALTERNATE ADMINISTRATOR) |
Mailing Address: | 730 Lovera Blvd Suite 100 San Antonio |
State: | TX US |
Postal Code: | 782121151 |
Phone Number: | 2105304788 |
Fax Number: | 2102814028 |
NPI Enumeration Date: | 05/27/2014 |
NPI Last Update Date: | 01/20/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 253Z00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Agencies |
Taxonomy Classification: | In Home Supportive Care |
Taxonomy Specialization: | |
Taxonomy Definition: | An In Home Supportive Care Agency provides services in the patient |