45D2243819 CLIA NUMBER - GROWING CAPABILITIES HILLSIDE RIDGE HOUSE

Laboratory Demographics

CLIA Number: 45D2243819

Facility Name: GROWING CAPABILITIES HILLSIDE RIDGE HOUSE

Facility Address:
14727 HILLSIDE RIDGE
SAN ANTONIO, TX
ZIP 78233
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Facility Phone Number: 210 494-1030

Facility Type: Intermediate Care Facility for Mentally Retarded

Certificate Type: Waiver

NPI Number: 1760605323

Taxonomy: 315P00000X - Intermediate Care Facility, Intellectual Disabilities
An intermediate care facility providing services for individuals with intellectual disabilities.

CLIA Record

Field Name	Field Value
CLIA Number	45D2243819
LAB Type	Intermediate Care Facility for Mentally Retarded
Facility Name	GROWING CAPABILITIES HILLSIDE RIDGE HOUSE
Street	14727 HILLSIDE RIDGE
City	SAN ANTONIO
State	TX
ZIP	78233
Phone	210 494-1030
CertificateType	4
CertificateEffectiveDate	11/23/2023
CertificateExpirationDate	11/22/2025
FacilityType	Waiver

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This page was last updated on: 4/23/2024