Provider Demographics
NPI:1174678361
Name:PARLAND PLACE COMMUNITY LIVING INC.
Entity Type:Organization
Organization Name:PARLAND PLACE COMMUNITY LIVING INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-828-1460
Mailing Address - Street 1:123 PARLAND PL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-6529
Mailing Address - Country:US
Mailing Address - Phone:210-828-1460
Mailing Address - Fax:210-828-3784
Practice Address - Street 1:123 PARLAND PL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-6529
Practice Address - Country:US
Practice Address - Phone:210-828-1460
Practice Address - Fax:210-828-3784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2008-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX010287310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1004326OtherDADS
TX1001254OtherDADS
TX1001255OtherDADS