Organization
INGRAM ASSISTED LIVING LLC
Active
Other names
Ingram Assisted Living
Organization subpart
No
Provider details
NPI number
Authorized official
DORU NICHITEAN (MANAGER)
(206) 504-9660
Entity
Organization
Contact information
Practice address
6207 THUNDER DR, SAN ANTONIO, TX 78238-3452
(206) 504-9660
Mailing address
6207 THUNDER DR, SAN ANTONIO, TX 78238-3452
(206) 504-9660
Taxonomy
Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
—
—
Other
Enumeration date
11/08/2024
Last updated
11/08/2024
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