Organization
ANCINO HEIGHTS ASSISTED LIVING FACILITY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED H GHANNAM (CEO)
(210) 639-9112
Entity
Organization
Contact information
Practice address
5002 WEST AVE, SAN ANTONIO, TX 78213-2710
(210) 639-9112
(210) 366-9042
Mailing address
5002 WEST AVE, SAN ANTONIO, TX 78213-2710
(210) 639-9112
(210) 366-9042
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
311500000X
Alzheimer Center (Dementia Center)
—
—
320700000X
Physical Disabilities Residential Treatment Facility
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
06/08/2016
Last updated
06/08/2016
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