Provider Demographics
NPI:1790799245
Name:MAYFIELD CARE CENTER
Entity Type:Organization
Organization Name:MAYFIELD CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL RECORDS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARI
Authorized Official - Middle Name:
Authorized Official - Last Name:COOK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-924-5533
Mailing Address - Street 1:328 W.MAYFIELD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221
Mailing Address - Country:US
Mailing Address - Phone:210-924-5533
Mailing Address - Fax:
Practice Address - Street 1:328 W.MAYFIELD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221
Practice Address - Country:US
Practice Address - Phone:210-924-5533
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX313MOOOOOX313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility