ENHANCED LIVING SERVICES LTD NPI 1679539761

NPI Information

NPI: 1679539761
Provider Name: ENHANCED LIVING SERVICES LTD

Other Name: PHEASANT RIDGE

Classification: Intermediate Care Facility, Mental Illness - 310500000X
Entity Type: Organization
Address:
835 PROTON RD
SAN ANTONIO, TX
ZIP 78258
Phone: (210) 558-3097
Get Directions

ENHANCED LIVING SERVICES LTD is an intermediate care facility mental illness in San Antonio, TX. The provider is a nursing facility that provides an intermediate level of nursing care to individuals whose functional abilities are significantly compromise by mental illness. ENHANCED LIVING SERVICES LTD NPI is 1679539761. The provider is registered as an organization entity type.
The provider Other Name Is Pheasant Ridge.

The provider's business location address is:

835 PROTON RD
SAN ANTONIO, TX
ZIP 78258-203
Phone: (210) 558-3097
Fax: (210) 558-9791

The provider's authorized official is Mike Hawker .
The authorized official title is Cfo and has the following contact phone number (210) 340-7155.

The enumeration date for this NPI number is 4/26/2006 and was last updated on 6/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	310500000X	Intermediate Care Facility, Mental Illness				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001012493	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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