Provider Demographics
NPI:1528268018
Name:ENHANCE LIVING SERVICES
Entity type:Organization
Organization Name:ENHANCE LIVING SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-340-7155
Mailing Address - Street 1:835 PROTON RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78258-4203
Mailing Address - Country:US
Mailing Address - Phone:210-558-3097
Mailing Address - Fax:210-558-9791
Practice Address - Street 1:5303 VISTA RUN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-4684
Practice Address - Country:US
Practice Address - Phone:210-558-3097
Practice Address - Fax:210-558-9791
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENHANCED LIVING SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-23
Last Update Date:2007-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities