Provider Demographics
NPI:1841966496
Name:PRIVATE HEALTHCARE FACILITIES
Entity type:Organization
Organization Name:PRIVATE HEALTHCARE FACILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:FAITH
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-464-3611
Mailing Address - Street 1:902 KITTY HAWK RD STE 170487
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3825
Mailing Address - Country:US
Mailing Address - Phone:866-996-2340
Mailing Address - Fax:888-329-2091
Practice Address - Street 1:607 OMAR CIR
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-1419
Practice Address - Country:US
Practice Address - Phone:866-996-2340
Practice Address - Fax:888-329-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QB0400XAmbulatory Health Care FacilitiesClinic/CenterBirthing