Great Life Services, LLC

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

GREAT LIFE SERVICES, LLC

Practice address

9033 Aero St Ste 101
San Antonio, TX 78217-6343

Phone

(210) 844-7487

Fax

(210) 579-1314

NPI assigned

May 4, 2016

Last updated

Jan 5, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gisele L Santana

Title

Ceo

Phone

(210) 656-1633

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1462320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672876800000",
    "number": "1174978548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 AERO ST STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176343",
            "telephone_number": "210-844-7487",
            "fax_number": "210-579-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 AERO ST STE 101",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782176343",
            "telephone_number": "210-844-7487",
            "fax_number": "210-579-1314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6534 Candlecane Cir",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782441914",
            "country_code": "US",
            "telephone_number": "210-844-7487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GREAT LIFE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-04",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A",
        "authorized_official_last_name": "SANTANA",
        "authorized_official_first_name": "GISELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "210-656-1633"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320900000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.