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AUTUMN LEAVES ASSISTED LIVING CARE INC NPI 1992841746


NPI Information

NPI: 1992841746
Provider Name: AUTUMN LEAVES ASSISTED LIVING CARE INC

Doing Business As: AUTUMN LEAVES ASSISTED LIVING INC

Classification: Custodial Care Facility - 311ZA0620X
Entity Type: Organization

Specialization: Adult Care Home

Address:
6411 RIDGE PLACE ST
SAN ANTONIO, TX
ZIP 78250
Phone: (210) 256-0553
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AUTUMN LEAVES ASSISTED LIVING CARE INC is an adult care home custodial care facility in San Antonio, TX. The provider is a custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. AUTUMN LEAVES ASSISTED LIVING CARE INC NPI is 1992841746. The provider is registered as an organization entity type.
The provider Is Doing Business As Autumn Leaves Assisted Living Inc.

The provider's business location address is:

6411 RIDGE PLACE ST
SAN ANTONIO, TX
ZIP 78250-038
Phone: (210) 256-0553
Fax: (210) 680-1343

The provider's authorized official is Wilma Julia La Croix .
The authorized official title is Owner and has the following contact phone number (210) 256-0553.

The enumeration date for this NPI number is 1/29/2007 and was last updated on 9/30/2021.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1311ZA0620XCustodial Care FacilityAdult Care Home030361TEXASYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11992841746MEDICAIDTEXAS

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: 4/28/2024

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