Provider Demographics
NPI:1538104112
Name:POST ACUTE MEDICAL AT SAN ANTONIO LLC
Entity Type:Organization
Organization Name:POST ACUTE MEDICAL AT SAN ANTONIO LLC
Other - Org Name:WARM SPRINGS REHABILITATION CENTER - NORTHWEST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:MISITANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-731-9660
Mailing Address - Street 1:1828 GOOD HOPE ROAD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:ENOLA
Mailing Address - State:PA
Mailing Address - Zip Code:17019-1203
Mailing Address - Country:US
Mailing Address - Phone:717-731-9660
Mailing Address - Fax:210-829-8741
Practice Address - Street 1:7616 CULEBRA RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-1476
Practice Address - Country:US
Practice Address - Phone:210-682-2346
Practice Address - Fax:210-681-7192
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2016-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000643261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0211724-01Medicaid
TX45-3035Medicare ID - Type UnspecifiedMEDICARE NUMBER