Provider Demographics
NPI:1760825269
Name:PRIMROSE WELLNESS GROUP, LLC
Entity Type:Organization
Organization Name:PRIMROSE WELLNESS GROUP, LLC
Other - Org Name:PRIMROSE LANE ADULT DAY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER-DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GARZA
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:210-647-8300
Mailing Address - Street 1:6812 BANDERA RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-1369
Mailing Address - Country:US
Mailing Address - Phone:210-647-8300
Mailing Address - Fax:210-647-8304
Practice Address - Street 1:6812 BANDERA RD
Practice Address - Street 2:SUITE 124
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-1369
Practice Address - Country:US
Practice Address - Phone:210-647-8300
Practice Address - Fax:210-647-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2013-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX135916261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care