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Organization
LAKEWOOD SENIOR LIVING OF ALTA VISTA LLC
Active
Organization
LAKEWOOD SENIOR LIVING OF ALTA VISTA LLC
Active
Other names
Lakewood Senior Living of Alta Vista
Organization subpart
No
Provider details
NPI number
Authorized official
MS. APRIL M PUCCETTI (ADMINISTRATOR)
(205) 320-7507
Entity
Organization
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(210) 735-9233
(210) 735-0164
Mailing address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(210) 735-9233
(210) 735-0164
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115822
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013791
—
TX
Enumeration date
09/20/2006
Last updated
04/28/2010
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