Provider Demographics
NPI:1164563235
Name:SIGNATURE HEALTHCARE SERVICES, I, LLC
Entity Type:Organization
Organization Name:SIGNATURE HEALTHCARE SERVICES, I, LLC
Other - Org Name:SIGNATURE HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO, OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:B
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:BA,MA,LNFA,LHA
Authorized Official - Phone:830-758-1889
Mailing Address - Street 1:590 E MAIN ST STE E
Mailing Address - Street 2:P.O. BOX 3176
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4772
Mailing Address - Country:US
Mailing Address - Phone:830-758-1889
Mailing Address - Fax:830-758-1714
Practice Address - Street 1:590 E MAIN ST STE E
Practice Address - Street 2:SAME
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4772
Practice Address - Country:US
Practice Address - Phone:830-758-1889
Practice Address - Fax:830-758-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010320311Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility