# GUADALUPE COUNTY HOSPITAL BOARD

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

## Provider details

- **NPI number:** 1760478200
- **Authorized official:** SOON BURNAM (TREASURER OF MANAGEMENT COMPANY)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 603 CORINNE DR, SAN ANTONIO, TX 78218-3303
- **Practice address phone:** (210) 824-7331
- **Practice address fax:** (210) 824-1334
- **Mailing address:** 603 CORINNE DR, SAN ANTONIO, TX 78218-3303
- **Mailing address phone:** (210) 824-7331
- **Mailing address fax:** (210) 824-7331

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 111489 | TX | Yes |

## Other

- **Enumeration date:** 09/20/2005
- **Last updated:** 03/10/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001004268 | — | TX |