Provider Demographics
NPI:1871037135
Name:GLEN OAKS HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:GLEN OAKS HEALTH CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:GABRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FELDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-901-8864
Mailing Address - Street 1:5822 ROYAL HVN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78239-1407
Mailing Address - Country:US
Mailing Address - Phone:210-901-8864
Mailing Address - Fax:512-949-5043
Practice Address - Street 1:5822 ROYAL HVN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78239-1407
Practice Address - Country:US
Practice Address - Phone:210-901-8864
Practice Address - Fax:512-949-5043
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-06
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities