Charter Healthcare of San Antonio, LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

CHARTER HEALTHCARE OF SAN ANTONIO, LLC

Practice address

2819 NW Loop 410 Ste C
San Antonio, TX 78230

Phone

(210) 979-9933

Fax

(210) 979-9932

NPI assigned

Aug 31, 2012

Last updated

Sep 10, 2021By 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

Sylvie Boal

Title

Corporate Counsel

Phone

(909) 644-4965

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1346371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631232000000",
    "number": "1215286547",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2819 NW LOOP 410 STE C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782305105",
            "telephone_number": "210-979-9933",
            "fax_number": "210-979-9932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2819 NW LOOP 410 STE C",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78230",
            "telephone_number": "210-979-9933",
            "fax_number": "210-979-9932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARTER HEALTHCARE OF SAN ANTONIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-31",
        "last_updated": "2021-09-10",
        "certification_date": "2021-04-21",
        "status": "A",
        "authorized_official_last_name": "BOAL",
        "authorized_official_first_name": "SYLVIE",
        "authorized_official_title_or_position": "CORPORATE COUNSEL",
        "authorized_official_telephone_number": "909-644-4965"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111751704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.