Provider Demographics
NPI:1225047939
Name:CHAPA RESIDENTIAL CARE HOME
Entity Type:Organization
Organization Name:CHAPA RESIDENTIAL CARE HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:DUNCAN
Authorized Official - Last Name:CHAPA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-665-5294
Mailing Address - Street 1:216 W COUNTY ROAD 5719
Mailing Address - Street 2:
Mailing Address - City:DEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:78016-4028
Mailing Address - Country:US
Mailing Address - Phone:830-709-4420
Mailing Address - Fax:830-709-5038
Practice Address - Street 1:216 W COUNTY ROAD 5719
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-4028
Practice Address - Country:US
Practice Address - Phone:830-709-4420
Practice Address - Fax:830-709-5038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0005783104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances