Provider Demographics
NPI:1164475778
Name:SAN ANGELO AIDS FOUNDATION
Entity Type:Organization
Organization Name:SAN ANGELO AIDS FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GUERRERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-658-3634
Mailing Address - Street 1:334 W CONCHO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6309
Mailing Address - Country:US
Mailing Address - Phone:325-658-3634
Mailing Address - Fax:325-658-3703
Practice Address - Street 1:334 W CONCHO AVE
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6309
Practice Address - Country:US
Practice Address - Phone:325-658-3634
Practice Address - Fax:325-658-3703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare