# FOURTEEN LAC INC

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

## Provider details

- **NPI number:** 1710919592
- **Authorized official:** MRS. CATHLEEN A BETHAY RN (CEO/PRESIDENT)
- **Authorized official phone:** (210) 546-2147

## Contact information

- **Practice address:** 13750 SAN PEDRO AVE, SUITE 600, SAN ANTONIO, TX 78232-4375
- **Practice address phone:** (210) 546-2147
- **Practice address fax:** (210) 546-2187
- **Mailing address:** 13750 SAN PEDRO AVE, SUITE 600, SAN ANTONIO, TX 78232-4375
- **Mailing address phone:** (210) 546-2147
- **Mailing address fax:** (210) 546-2187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251E00000X | Home Health Agency | 010656 | TX | Yes |

## Other

- **Enumeration date:** 07/06/2006
- **Last updated:** 08/22/2020