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Organization

MILAGRO DISCOVERY HOME AND COMMUNITY HEALTHCARE SERVICE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CARLA EVETTE THOMAS (EXECUTIVE DIRECTOR)
(210) 815-1385
Entity
Organization

Contact information

Practice address
6810 BANDERA RD STE 1, SAN ANTONIO, TX 78238-1468
(210) 446-4706
Mailing address
PO BOX 760595, SAN ANTONIO, TX 78245-0595
(210) 815-1385

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
261QA0600X
Adult Day Care Clinic/Center
143171
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3498107
TX
Enumeration date
12/13/2007
Last updated
11/19/2015
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