Provider Demographics
NPI:1104380245
Name:MISSION EVENT SENIOR CENTER LLC
Entity Type:Organization
Organization Name:MISSION EVENT SENIOR CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-860-8855
Mailing Address - Street 1:7711 BROADWAY ST APT 13C
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-3205
Mailing Address - Country:US
Mailing Address - Phone:210-860-8855
Mailing Address - Fax:
Practice Address - Street 1:5614 SOUTH FLORES STREET
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214
Practice Address - Country:US
Practice Address - Phone:210-860-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-23
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care