# AMISTAD NURSING HOME INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1750321139
- **Authorized official:** MR. JOHN M. WADE (VICE PRESIDENT)
- **Authorized official phone:** (830) 278-5641

## Contact information

- **Practice address:** 200 RIVERSIDE DR, UVALDE, TX 78801-5727
- **Practice address phone:** (830) 278-5641
- **Practice address fax:** (830) 278-5498
- **Mailing address:** 200 RIVERSIDE DR, UVALDE, TX 78801-5727
- **Mailing address phone:** (830) 278-5641
- **Mailing address fax:** (830) 278-5498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 117473 | TX | Yes |

## Other

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

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004216 | — | TX |