Organization
AMISTAD RESIDENTAL FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NANCY MURRAH (PROVIDER)
(210) 725-6293
Entity
Organization
Contact information
Practice address
309 W NORWOOD CT, SAN ANTONIO, TX 78212-2222
(210) 832-9578
(210) 832-9578
Mailing address
309 W NORWOOD CT, SAN ANTONIO, TX 78212-2222
(210) 832-9578
(210) 832-9578
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
127885
TX
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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