Stonebrook Manor At Broadway

LBN: Broadway Convalescent Center, L.P.
Stonebrook Manor At Broadway is an health care organization with primary practice located at 1841 Flamingo , San Antonio TX 78209. The organization recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Skilled Nursing Facility, Suppliers / Nursing Facility Supplies, Suppliers / Parenteral & Enteral Nutrition. Nursing & Custodial Care Facilities / Skilled Nursing Facility is the primary health care specialty. Broadway Convalescent Center, L.P. can be contacted via phone (210) 824-5324, or through Licari, Peter J via phone (215) 441-7700.

Contact Information

Primary practice address
1841 Flamingo San Antonio TX 78209
Phone: (210) 824-5324
Fax: (210) 824-5360
Website:
Map and Directions
Authorized official contact:
Name: Licari, Peter J
Phone: (215) 441-7700

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Skilled Nursing Facility 314000000X 113793 Texas
Suppliers / Nursing Facility Supplies 332BN1400X 120074 Texas
Suppliers / Parenteral & Enteral Nutrition 332BP3500X 120074 Texas

Profile Details

NPI number 1245267319
LBN Legal business name Broadway Convalescent Center, L.P.
DBA Doing business as Stonebrook Manor At Broadway
Authorized official Licari, Peter J
Entity Organization
Organization subpart 1 No
Enumeration date Jun 26th, 2006
Last updated Oct 25th, 2007 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245267319 NPPES
Texas MEDICAID 004354

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