Organization
OUR PERSONAL HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINA C. WILLIAMS (OWNER)
(210) 227-7054
Entity
Organization
Contact information
Practice address
3803 WILLOWWOOD BLVD, SAN ANTONIO, TX 78219-2537
(210) 227-7054
Mailing address
3807 WILLOWWOOD BLVD, SAN ANTONIO, TX 78219-2537
(210) 227-7054
(210) 227-7054
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
118088
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
F50018860
—
TX
Enumeration date
05/02/2007
Last updated
06/18/2008
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