Organization
BERNICE'S ROOM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS TRACI ALLEN RN (CEO)
(210) 452-7046
Entity
Organization
Contact information
Practice address
734 N NEW BRAUNFELS AVE STE 103, SAN ANTONIO, TX 78202-2429
(210) 904-1164
Mailing address
734 N NEW BRAUNFELS AVE STE 103, SAN ANTONIO, TX 78202-2429
(210) 904-1164
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
—
—
177F00000X
Lodging Provider
—
—
251K00000X
Public Health or Welfare Agency
—
—
253Z00000X
In Home Supportive Care Agency
—
—
310400000X
Assisted Living Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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