Provider Demographics
NPI:1053867879
Name:A DAUGHTER'S LOVE FOR SENIOR CARE AT STONE OAK
Entity Type:Organization
Organization Name:A DAUGHTER'S LOVE FOR SENIOR CARE AT STONE OAK
Other - Org Name:A DAUGHTER'S LOVE FOR SENIOR CARE AT STONE OAK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:NIKKI
Authorized Official - Middle Name:ALVARADO
Authorized Official - Last Name:AGNEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-753-4300
Mailing Address - Street 1:PO BOX 15861
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-9061
Mailing Address - Country:US
Mailing Address - Phone:210-753-4300
Mailing Address - Fax:210-855-5169
Practice Address - Street 1:4092 TPC PKWY
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261
Practice Address - Country:US
Practice Address - Phone:210-753-4300
Practice Address - Fax:210-855-5169
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home