Provider Demographics
NPI:1457593089
Name:CARDINAL SENIOR CARE LLC
Entity Type:Organization
Organization Name:CARDINAL SENIOR CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HAMID
Authorized Official - Middle Name:
Authorized Official - Last Name:MANGALJI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-323-9187
Mailing Address - Street 1:4402 VANCE JACKSON RD STE 202
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-5334
Mailing Address - Country:US
Mailing Address - Phone:210-323-9187
Mailing Address - Fax:866-702-1663
Practice Address - Street 1:4402 VANCE JACKSON RD STE 202
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-5334
Practice Address - Country:US
Practice Address - Phone:210-684-7080
Practice Address - Fax:866-702-1663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-27
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care