Organization · NPI-2

Ancino Heights Assisted Living Facility INC.

Assisted Living Facility · San Antonio, TX

NPI number1285083485

StatusActive

Last updated in NPPESJun 8, 2016

Details

NPI: 1285083485
Entity type: Organization (NPI-2)
Legal business name: Ancino Heights Assisted Living Facility INC.
Organization subpart: No
Enumeration date: Jun 8, 2016
Last updated: Jun 8, 2016

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
310400000X	Assisted Living Facility	–	–	Yes
3104A0625X	Assisted Living Facility, Assisted Living, Mental Illness	–	–
311500000X	Alzheimer Center (Dementia Center)	–	–
320700000X	Residential Treatment Facility, Physical Disabilities	–	–

Practice location

5002 West Ave
San Antonio, TX 78213-2710

Phone 210-639-9112 · Fax 210-366-9042

Mailing address

5002 West Ave
San Antonio, TX 78213-2710

Phone 210-639-9112 · Fax 210-366-9042

Authorized official

Mohamed H Ghannam
Ceo
2106399112

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