5423 Hamilton Wolfe Road Operations LLC
Skilled Nursing Facility in San Antonio, TX. Organization (NPI-2).
NPI number1124412077
StatusActive
Last updated in NPPESOct 24, 2017
Details
- NPI
- 1124412077
- Entity type
- Organization (NPI-2)
- Legal business name
- 5423 Hamilton Wolfe Road Operations LLC
- Organization subpart
- Yes
- Enumeration date
- Mar 27, 2015
- Last updated
- Oct 24, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | 144843 | TX | Yes |
Other names
- Powerback Rehabilitation San Antonio (Doing Business As)
Practice location
5423 Hamilton Wolfe RdSan Antonio, TX 78229-4344
Phone 210-694-9494
Mailing address
5423 Hamilton Wolfe RdSan Antonio, TX 78229-4344
Phone 210-694-9494
Authorized official
Michael T. Berg
Assistant Secretary
5054684752
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