Organization
LA ESTRELLA-LAKESIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES S RAMON (REGISTERED AGENT)
(210) 432-5050
Entity
Organization
Contact information
Practice address
1000 CINCINNATI AVE, SAN ANTONIO, TX 78201-6030
(210) 432-5050
(210) 432-5050
Mailing address
2301 SAN FERNANDO ST, SAN ANTONIO, TX 78207-5229
(210) 432-5050
(210) 432-5050
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
TX
Other
Enumeration date
12/09/2010
Last updated
12/09/2010
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