Staten, Costance Yvette

Staten, Costance Yvette is an sole proprietor health care provider with primary practice located at 7000 Gulfshore , San Antono TX 78244. She recently has 3 registered licenses in different health care specialties including Nursing & Custodial Care Facilities / Assisted Living Facility, Nursing & Custodial Care Facilities / Assisted Living, Mental Illness, Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances. Nursing & Custodial Care Facilities / Assisted Living Facility is her primary health care specialty. Staten, Costance Yvette can be contacted via phone (210) 707-7784.

Contact Information

Primary practice address
7000 Gulfshore San Antono TX 78244
Phone: (210) 707-7784
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing & Custodial Care Facilities / Assisted Living Facility 310400000X 121763 Texas
Nursing & Custodial Care Facilities / Assisted Living, Mental Illness 3104A0625X 121763 Texas
Nursing & Custodial Care Facilities / Assisted Living, Behavioral Disturbances 3104A0630X 21763 Texas

Profile Details

NPI number 1588822308
LBN Legal business name Staten, Costance Yvette
Credentials DIRECTOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 29th, 2008
Last updated May 29th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588822308 NPPES
Texas MEDICAID 51430089

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