Provider Demographics
NPI:1962069971
Name:KOVAL'S ADULT FOSTER HOME
Entity type:Organization
Organization Name:KOVAL'S ADULT FOSTER HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GLADYS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-534-9451
Mailing Address - Street 1:802 MONTICELLO CT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-2232
Mailing Address - Country:US
Mailing Address - Phone:210-534-9451
Mailing Address - Fax:
Practice Address - Street 1:804 MONTICELLO CT
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-2232
Practice Address - Country:US
Practice Address - Phone:210-534-9451
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HIGHLAND GARDENS PERSONAL CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-05-24
Last Update Date:2019-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home