# CALAVARAS CREEK HEALTHCARE LLC

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

## Provider details

- **NPI number:** 1720632359
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 3838 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78222-3556
- **Practice address phone:** (210) 581-2273
- **Practice address fax:** (210) 572-6994
- **Mailing address:** 3838 E SOUTHCROSS BLVD, SAN ANTONIO, TX 78222-3556
- **Mailing address phone:** (210) 581-2273
- **Mailing address fax:** (210) 572-6994

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 07/31/2019
- **Last updated:** 01/20/2023