NPIMap

Organization Active NPI

Enhanced Living Center LTC

  • Nursing Facility/Intermediate Care Facility
  • San Antonio, TX
National Provider Identifier
1609846997
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
114887 Issued in TX
Legal business name
ENHANCED LIVING CENTER LTC
Practice address
845 Proton Rd
San Antonio, TX 78258-4203
Phone
(210) 582-3712
Fax
(210) 582-3812
NPI assigned
Jan 26, 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
Mike Hawker
Title
Cfo
Phone
(210) 582-3710

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 114887 TX Primary

Addresses

Primary practice location

845 Proton Rd
San Antonio, TX 78258-4203

Mailing address

845 Proton Rd
San Antonio, TX 78258-4203
Phone (210) 582-3712

Other identifiers 1

IdentifierTypeStateIssuer
0010102495MedicaidTX

National Provider Directory

National Provider Directory
Tax ID family
Enhance Living Services15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1609846997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 PROTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584203",
            "telephone_number": "210-582-3712",
            "fax_number": "210-582-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 PROTON RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782584203",
            "telephone_number": "210-582-3712",
            "fax_number": "210-582-3812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENHANCED LIVING CENTER LTC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAWKER",
        "authorized_official_first_name": "MIKE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "210-582-3710"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "114887",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0010102495",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.