Organization
ENCHANTMENT LIVING HHC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLYN RANDLE (ADMINISTRATOR)
(210) 273-8016
Entity
Organization
Contact information
Practice address
5927 IRIS ISLE, SAN ANTONIO, TX 78218-3091
(210) 273-8016
Mailing address
5927 IRIS ISLE, SAN ANTONIO, TX 78218-3091
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
07/01/2017
Last updated
07/01/2017
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