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Organization

ENHANCED LIVING CENTER LTC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MIKE HAWKER (CFO)
(210) 582-3710
Entity
Organization

Contact information

Practice address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 582-3712
(210) 582-3812
Mailing address
845 PROTON RD, SAN ANTONIO, TX 78258-4203
(210) 582-3712
(210) 582-3812

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
114887
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010102495
TX
Enumeration date
01/26/2006
Last updated
08/22/2020
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