# LA CLINICA AMISTAD, INC.

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

## Provider details

- **NPI number:** 1841436938
- **Authorized official:** CHARLES HENDERSON LMSW-AP (PRESIDENT/CEO)
- **Authorized official phone:** (210) 872-4302

## Contact information

- **Practice address:** 17319 GARWOOD CHASE, SAN ANTONIO, TX 78247-5839
- **Practice address phone:** (210) 872-4302
- **Mailing address:** 17319 GARWOOD CHASE, SAN ANTONIO, TX 78247-5839
- **Mailing address phone:** (210) 872-4302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 12/19/2008
- **Last updated:** 12/19/2008