NPIMap

Organization Active NPI

Mission Road Developmental Center

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
National Provider Identifier
1346327756
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X
License
104897 Issued in TX
Legal business name
MISSION ROAD DEVELOPMENTAL CENTER
Practice address
7618 Mockingbird LN
San Antonio, TX 78229-2624
Phone
(210) 349-8125
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Lora Butler
Title
Executive Director
Phone
(210) 334-2460

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual Disabilities Intermediate Care Facility 315P00000X 104897 TX Primary

Addresses

Primary practice location

7618 Mockingbird LN
San Antonio, TX 78229-2624

Mailing address

8706 Mission Rd
San Antonio, TX 78214-3140
Phone (210) 924-9265

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 45G814

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
Mission Road Developmental Center
Certification status
Active
Provider type (POS)
Intermediate care facility for individuals with intellectual disabilities
Participating since
Jul 18, 1991
Last certification
Jan 15, 2025
Beds
6
Ownership / control type
Private (non-profit)
Facility address
7618 Mockingbird LN
San Antonio, TX 78229

National Provider Directory

National Provider Directory
Tax ID family
Mission Road Developmental Center12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346327756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8706 MISSION RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782143140",
            "telephone_number": "210-924-9265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7618 MOCKINGBIRD LN",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782292624",
            "telephone_number": "210-349-8125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSION ROAD DEVELOPMENTAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BUTLER",
        "authorized_official_first_name": "LORA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "210-334-2460"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "TX",
            "license": "104897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

Verify at the official NPI Registry.