Organization · NPI-2

Amber Lantern, LLC

Community Based Residential Treatment Facility, Mental Illness · San Antonio, TX

NPI number1548036676
StatusActive
Last updated in NPPESDec 4, 2023

Details

NPI
1548036676
Entity type
Organization (NPI-2)
Legal business name
Amber Lantern, LLC
Organization subpart
No
Enumeration date
Nov 29, 2023
Certification date
Dec 4, 2023
Last updated
Dec 4, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320800000X Community Based Residential Treatment Facility, Mental Illness––Yes
261QM0850X Clinic/Center, Adult Mental Health––

Practice location

8318 Bluff Bend Dr
San Antonio, TX 78250-3202

Phone 210-890-5504

Mailing address

8318 Bluff Bend Dr
San Antonio, TX 78250-3202

Authorized official

Dylan Garrett
Director Of Communications
2108905504

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