Provider Demographics
NPI:1306049291
Name:CORPORATE ASSISTANT LIVING
Entity type:Organization
Organization Name:CORPORATE ASSISTANT LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:NENE
Authorized Official - Middle Name:ANGUM
Authorized Official - Last Name:AKWAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-349-4800
Mailing Address - Street 1:6323 SOVEREIGN ST
Mailing Address - Street 2:SUITE 172
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-5138
Mailing Address - Country:US
Mailing Address - Phone:210-349-4800
Mailing Address - Fax:210-349-5575
Practice Address - Street 1:6323 SOVEREIGN ST
Practice Address - Street 2:SUITE 172
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-5138
Practice Address - Country:US
Practice Address - Phone:210-349-4800
Practice Address - Fax:210-349-5575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities