Provider Demographics
NPI:1801133152
Name:ESPLANADE GARDENS SENIOR INC
Entity type:Organization
Organization Name:ESPLANADE GARDENS SENIOR INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CAMPUS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIAZ -PETERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-566-7600
Mailing Address - Street 1:10790 TOEPPERWEIN RD
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2441
Mailing Address - Country:US
Mailing Address - Phone:210-566-7600
Mailing Address - Fax:210-566-7605
Practice Address - Street 1:10790 TOEPPERWEIN RD
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2441
Practice Address - Country:US
Practice Address - Phone:210-566-7600
Practice Address - Fax:210-566-7605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-07
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0303643104A0630X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances