Provider Demographics
NPI:1609873272
Name:SARAH ROBERTS FRENCH HOME
Entity Type:Organization
Organization Name:SARAH ROBERTS FRENCH HOME
Other - Org Name:THE SARAH ROBERTS FRENCH HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:NURSING FACILITY ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MONA
Authorized Official - Middle Name:LISA
Authorized Official - Last Name:RUDD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-736-4238
Mailing Address - Street 1:1315 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78201-5944
Mailing Address - Country:US
Mailing Address - Phone:210-736-4238
Mailing Address - Fax:210-737-7151
Practice Address - Street 1:1315 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78201-5944
Practice Address - Country:US
Practice Address - Phone:210-736-4238
Practice Address - Fax:210-737-7151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-28
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4373313M00000X
TX1029640001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1029640001Medicare NSC