La Clinica Amistad, Inc.

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

Legal business name

LA CLINICA AMISTAD, INC.

Practice address

17319 Garwood Chase
San Antonio, TX 78247-5839

Phone

(210) 872-4302

NPI assigned

Dec 19, 2008

Organization subpart

No

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

Authorized official

Name

Charles Henderson, LMSW-APNPI 1972779379

Title

President/Ceo

Phone

(210) 872-4302

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Charles Henderson, LMSW-AP

  • Counselor
  • San Antonio, TX
  • NPI 1972779379
  NPD (past) Authorized official

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

{
    "created_epoch": "1229644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229644800000",
    "number": "1841436938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17319 GARWOOD CHASE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782475839",
            "telephone_number": "210-872-4302"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17319 GARWOOD CHASE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782475839",
            "telephone_number": "210-872-4302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA CLINICA AMISTAD, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-19",
        "last_updated": "2008-12-19",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "210-872-4302",
        "authorized_official_credential": "LMSW-AP"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Public Health or Welfare Agency in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Public Health or Welfare Agency in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2008; 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.