Provider Demographics
NPI:1922110584
Name:CORPORATE ASSISTANT LIVING
Entity Type:Organization
Organization Name:CORPORATE ASSISTANT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EMMANUEL
Authorized Official - Middle Name:CHUKWUDI
Authorized Official - Last Name:AKWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-349-4800
Mailing Address - Street 1:6326 SOVEREIGN ST
Mailing Address - Street 2:SUITE 140B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5139
Mailing Address - Country:US
Mailing Address - Phone:210-349-4800
Mailing Address - Fax:210-349-5575
Practice Address - Street 1:6326 SOVEREIGN ST
Practice Address - Street 2:SUITE 140B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5139
Practice Address - Country:US
Practice Address - Phone:210-349-4800
Practice Address - Fax:210-349-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services