Provider Demographics
NPI:1790009777
Name:ST ALPHONSA HEALTH CARE INC
Entity Type:Organization
Organization Name:ST ALPHONSA HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WILSON
Authorized Official - Middle Name:
Authorized Official - Last Name:OOMMEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-680-5562
Mailing Address - Street 1:7713 HIGHLAND PARK
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78250-5127
Mailing Address - Country:US
Mailing Address - Phone:210-680-5562
Mailing Address - Fax:210-680-5562
Practice Address - Street 1:7713 HIGHLAND PARK
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78250-5127
Practice Address - Country:US
Practice Address - Phone:210-680-5562
Practice Address - Fax:210-680-5562
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-20
Last Update Date:2010-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health