Organization
MISSION ROAD DEVELOPMENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORA BUTLER (EXECUTIVE DIRECTOR)
(210) 334-2460
Entity
Organization
Contact information
Practice address
7618 MOCKINGBIRD LN, SAN ANTONIO, TX 78229-2624
(210) 349-8125
Mailing address
8706 MISSION RD, SAN ANTONIO, TX 78214-3140
(210) 924-9265
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
104897
TX
Other
Enumeration date
11/01/2006
Last updated
08/22/2020
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