Organization
SHANE LLC
Active
Other names
Pinetree Lane
Organization subpart
No
Provider details
NPI number
Authorized official
DARIAN S WEST (CEO)
(210) 403-9372
Entity
Organization
Contact information
Practice address
2002 PINETREE LN, SAN ANTONIO, TX 78232-4938
(210) 403-9372
Mailing address
15427 BLACK CYN, SAN ANTONIO, TX 78232-4015
(210) 403-9372
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
—
—
Other
Enumeration date
02/06/2023
Last updated
07/10/2023
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