Organization
5423 HAMILTON WOLFE ROAD OPERATIONS LLC
Active
Parent organization
SUMMIT CARE LLC
Other names
PowerBack Rehabilitation San Antonio
Organization subpart
Yes
Provider details
NPI number
Legal business name
SUMMIT CARE LLC
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
5423 HAMILTON WOLFE RD, SAN ANTONIO, TX 78229-4344
(210) 694-9494
Mailing address
5423 HAMILTON WOLFE RD, SAN ANTONIO, TX 78229-4344
(210) 694-9494
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
144843
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001027706
—
TX
Enumeration date
03/27/2015
Last updated
10/24/2017
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