# ENHANCED LIVING CENTER LTC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609846997
- **Authorized official:** MIKE HAWKER (CFO)
- **Authorized official phone:** (210) 582-3710

## Contact information

- **Practice address:** 845 PROTON RD, SAN ANTONIO, TX 78258-4203
- **Practice address phone:** (210) 582-3712
- **Practice address fax:** (210) 582-3812
- **Mailing address:** 845 PROTON RD, SAN ANTONIO, TX 78258-4203
- **Mailing address phone:** (210) 582-3712
- **Mailing address fax:** (210) 582-3812

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 114887 | TX | Yes |

## Other

- **Enumeration date:** 01/26/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0010102495 | — | TX |