MISSION ROAD DEVLELOPMENTAL CENTER (NPI# 1255418653) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255418653 |
| Entity Type | Organization |
| Organization Name | MISSION ROAD DEVLELOPMENTAL CENTER |
| Practice Address |
460 Kopplow Pl San Antonio TX 78221-2921 |
| Mailing Address |
8706 Mission Rd San Antonio TX 78214-3140 |
| Practice Telephone | 2109219396 |
| Mailing Telephone | 2109249265 |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LORA BUTLER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2103342437 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 315P00000X | Intermediate Care Facility, Mentally Retarded | 110298 | TX | Nursing & Custodial Care Facilities |
| Street Address |
460 KOPPLOW PL |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78221-2921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174025613 | Alessi Royalando Jenkins | Registered Nurse | 11418 Hogan Cv, San Antonio, TX 78221 | 2018-03-01 |
| 1104299528 | Melissa Campos | Licensed Practical Nurse | Wellmed At Sw Military, 517 Sw Military Dr Ste A, San Antonio, TX 78221 | 2015-11-06 |
| 1083055834 | Southside Spinal Care Clinic LLC. | Chiropractor | 1730 Sw Military Dr., Suite 104c, San Antonio, TX 78221 | 2013-07-09 |
| 1164862934 | Robert A Castro | Dentist | 1926 Pleasanton Dr, San Antonio, TX 78221 | 2013-06-26 |
| 1215253851 | Maricella Araiza Falcon-marchiori | Occupational Therapy Assistant | 331 W Gerald, San Antonio, TX 78221 | 2010-04-07 |
| 1992029342 | Access Dental of Pleasanton, P.a. | Dentist | 803 Sw Military Drive, Suite #130, San Antonio, TX 78221 | 2010-03-15 |
| 1598804148 | San Juan Primary Home Care Agency | Home Health | 201 Rayburn Drive, San Antonio, TX 78221 | 2007-02-06 |
| 1669570412 | Cvs Pharmacy Inc | Pharmacy | 103 S W Military Drive, San Antonio, TX 78221 | 2006-09-20 |
| 1649389073 | H-e-b, Lp | Clinical Medical Laboratory | 735 Sw Military Dr, San Antonio, TX 78221 | 2006-08-30 |
| 1790799245 | Mayfield Care Center | Nursing Facility/Intermediate Care Facility | 328 W.mayfield, San Antonio, TX 78221 | 2006-07-28 |
| Find all providers in zip 78221 | ||||
| Taxonomy Code | 315P00000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Intermediate Care Facility, Mentally Retarded |
| (1) A public institution for care of the mentally retarded or people with related conditions. (2) An institution giving active treatment to mentally retarded or developmentally disabled persons or persons with related conditions. The primary purpose of the institution is to provide health or rehabilitative services to such individuals. |
| Notes: Sources: (1) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 403 (2) Paraphrased from Code of Federal Regulations #42, Public Health, Section 440.150(c). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134760002 | Premieant Inc | Intermediate Care Facility, Mentally Retarded | 6402 Regency Cv, San Antonio, TX 78249-4844 | 2019-10-02 |
| 1285299636 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 6647 Cades Cv, San Antonio, TX 78238-2238 | 2019-05-01 |
| 1730744186 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 7422 Quail Run Dr, San Antonio, TX 78209-3129 | 2019-05-01 |
| 1346692712 | Anchor Habilitation Service LLC | Intermediate Care Facility, Mentally Retarded | 18843 Redland Rd, San Antonio, TX 78259-3562 | 2016-07-08 |
| 1649609132 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5303 Vista Run Dr, San Antonio, TX 78247-4684 | 2013-11-05 |
| 1700215290 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 12342 Mapletree St, San Antonio, TX 78249-2429 | 2013-11-05 |
| 1316376924 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 14038 Boulder Oaks, San Antonio, TX 78247-3103 | 2013-11-04 |
| 1710316328 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5119 Stormy Sunset, San Antonio, TX 78247-1721 | 2013-11-04 |
| 1639508245 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 5223 Stormy Sunset, San Antonio, TX 78247-1723 | 2013-11-04 |
| 1902235518 | Educare Community Living Corporation - Texas | Intermediate Care Facility, Mentally Retarded | 17002 Vista Briar Dr, San Antonio, TX 78247-4636 | 2013-11-04 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78221 |
Please comment or provide details below to improve the information on MISSION ROAD DEVLELOPMENTAL CENTER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.