Organization
SAGEBRUSH LIVING CENTER LTD
Active
Other names
Sagebrush Living Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE HAWKER (CFO)
(210) 340-7155
Entity
Organization
Contact information
Practice address
1101 COLUMBIA, STAMFORD, TX 79553
(325) 773-2791
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 340-7155
Taxonomy
Speciality
Code
Description
License number
State
310500000X
Mental Illness Intermediate Care Facility
Primary
003705
TX
Other
Enumeration date
04/24/2006
Last updated
08/22/2020
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