Provider Demographics
NPI:1528408648
Name:ZABRINAS JOLLY BUNCH
Entity Type:Organization
Organization Name:ZABRINAS JOLLY BUNCH
Other - Org Name:PRIESTLEYS DIVINE CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZABRINA
Authorized Official - Middle Name:C
Authorized Official - Last Name:PRIESTLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-279-7839
Mailing Address - Street 1:6134 WISTERIA HL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78218-3108
Mailing Address - Country:US
Mailing Address - Phone:210-279-7839
Mailing Address - Fax:
Practice Address - Street 1:6134 WISTERIA HL
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-3108
Practice Address - Country:US
Practice Address - Phone:210-279-7839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-03
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home