INCARNATE WORD RETIREMENT COMMUNITY, INC.
Nursing at Broadway, San Antonio, TX

License number
Texas 000204
Category
Nursing
Type
Nursing Facility/Intermediate Care Facility
Owner
Name: STEVEN E. FULLER
Title: CHIEF EXECUTIVE OFFICER
Phone: (210) 829-7561
Address
Address
4707 Broadway St, San Antonio, TX 78209
National Provider ID: 1720289036
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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INCARNATE WORD RETIREMENT COMMUNITY, INC

4707 Broadway St, San Antonio, TX 78209

Industry:
Intermediate Care Facility Residential Care Services, Home Elder Care
Doing business as:
Village At Incarnate Word
Registration:
Apr 7, 1989
Phone:
(210) 829-7561 (Phone)
State ID:
0111050301
Business type:
Domestic Nonprofit Corporation
Directors:
Chilton Maverick (Director),Lupita Medina (Director, Vice Chairperson),Teresa Barrios-Ogden (Director),...
Agent:
Steven E Fuller,4707 Broadway, San Antonio, TX 78209 (Physical)
TIN:
30113360801

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