Organization
ROSETTA'S KEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIA ROSETTA JORDAN SPICER (OWNER)
(210) 602-8793
Entity
Organization
Contact information
Practice address
8930 FOURWINDS DR, SUITE 337, WINDCREST, TX 78239-1970
(210) 410-1595
(210) 590-0355
Mailing address
8930 FOURWINDS DR, SUITE 337, WINDCREST, TX 78239-1970
(210) 410-1595
(210) 590-0355
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
61621
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2826976
—
TX
Enumeration date
11/15/2012
Last updated
11/15/2012
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