Methodist Mission Home

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

METHODIST MISSION HOME

Doing business as

Providence Place

Practice address

6487 Whitby Rd
San Antonio, TX 78240-2131

Phone

(210) 696-2410

Fax

(210) 888-9550

NPI assigned

Aug 9, 2018

Last updated

Aug 9, 2018By 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

Angelica Nanez Cervantes

Title

Chief Program Officer

Phone

(210) 696-2410

Specialties & licenses 1

Addresses

Other names 1

• Providence Place Doing business as

Tax ID family

Methodist Mission Home2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Methodist Mission Home

  • Intellectual Disabilities Intermediate Care Facility
  • San Antonio, TX
  • NPI 1982919759
  NPD tax ID

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533772800000",
    "number": "1548749666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6487 WHITBY RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402131",
            "telephone_number": "210-696-2410",
            "fax_number": "210-888-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6487 WHITBY RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782402131",
            "telephone_number": "210-696-2410",
            "fax_number": "210-888-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHODIST MISSION HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A",
        "authorized_official_last_name": "CERVANTES",
        "authorized_official_first_name": "ANGELICA",
        "authorized_official_middle_name": "NANEZ",
        "authorized_official_title_or_position": "CHIEF PROGRAM OFFICER",
        "authorized_official_telephone_number": "210-696-2410"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Place",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Providence Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Methodist Healthcare System of San Antonio, LTD., LLP (Methodist ER Legacy Trails, a department of Methodist Hospital)
• Methodist Hospital Based Physicians PLLC
• Methodist Inpatient Management Group
• Methodist Medical Center ASC LP (Methodist Ambulatory Surgery Center Medical Center)
• Methodist Medical Group, PLLC
• Methodist Mission Home
• Methodist Physician Practices, PLLC
• Cristina Angela Metildi, M.D
• Metis Foundation
• Anthony Randolph Metoyer Jr., MA, NCC, LPC

• Mental Health Counselor in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.