Definitive Residential Care, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

DEFINITIVE RESIDENTIAL CARE, LLC

Practice address

20614 Stone Oak Pkwy # 2108
San Antonio, TX 78258-7374

Phone

(210) 983-9950

Fax

(888) 871-9804

NPI assigned

Jun 25, 2024

Last updated

Jun 25, 2024By 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

Yuketha Vonyonn Polk

Title

Owner

Phone

(210) 592-3710

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719273600000",
    "number": "1710721543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20614 STONE OAK PKWY # 2108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587374",
            "telephone_number": "210-983-9950",
            "fax_number": "888-871-9804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20614 STONE OAK PKWY # 2108",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782587374",
            "telephone_number": "210-983-9950",
            "fax_number": "888-871-9804"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEFINITIVE RESIDENTIAL CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "YUKETHA",
        "authorized_official_middle_name": "VONYONN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-592-3710"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2024; 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.