Organization
SAN ANTONIO III ENTERPRISES, LLC
Active
Other names
Mesa Vista Inn Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BLAKE (MANAGING MEMBER)
(817) 348-8959
Entity
Organization
Contact information
Practice address
5756 N KNOLL, SAN ANTONIO, TX 78240-2238
(210) 321-5200
(210) 321-5299
Mailing address
4150 INTERNATIONAL PLZ STE 600, FORT WORTH, TX 76109-4831
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/12/2019
Last updated
03/12/2019
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