Provider Demographics
NPI:1659696656
Name:SHARED VISION INC.
Entity Type:Organization
Organization Name:SHARED VISION INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JIM
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:HARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:210-977-8900
Mailing Address - Street 1:1339 W CHAVANEAUX RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-2607
Mailing Address - Country:US
Mailing Address - Phone:210-977-8900
Mailing Address - Fax:210-977-8909
Practice Address - Street 1:1339 W CHAVANEAUX RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-2607
Practice Address - Country:US
Practice Address - Phone:210-977-8900
Practice Address - Fax:210-977-8909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility