Organization
EXCEPTIONAL PROVIDER SERVICE, LLC
Active
Other names
Exceptional Pedi Care
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL CASTILLO (CEO/ADMINISTRATOR)
(210) 579-0223
Entity
Organization
Contact information
Practice address
8546 BROADWAY STE 206, SAN ANTONIO, TX 78217-6340
(210) 579-0223
(210) 579-0242
Mailing address
PO BOX 632, LEMING, TX 78050-0632
(210) 579-0223
(210) 579-0242
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
11/30/2020
Last updated
11/30/2020
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