# PECAN VALLEY HEALTHCARE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pecan Valley Rehabilitation and Healthcare Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700111754
- **Authorized official:** TIMOTHY CRANK (PRESIDENT)
- **Authorized official phone:** (210) 525-7993

## Contact information

- **Practice address:** 3838 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78222-3556
- **Practice address phone:** (210) 525-7993
- **Mailing address:** 8000 IH 10 W, SUITE 1500, SAN ANTONIO, TX 78230-3802
- **Mailing address phone:** (210) 525-7993
- **Mailing address fax:** (210) 525-7992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 129441 | TX | Yes |

## Other

- **Enumeration date:** 10/08/2009
- **Last updated:** 07/23/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001017939 | — | TX |
| 01 | — | 104259 | FACILITY ID | TX |