| Behavioral Support & Nursing Services, Llc | |
|
1600 Ne Loop 410 Ste 105 San Antonio TX 78209-1612 | |
| (210) 246-2334 | |
| Not Available |
| Full Name | Behavioral Support & Nursing Services, Llc |
|---|---|
| Speciality | Counselor |
| Location | 1600 Ne Loop 410 Ste 105, San Antonio, Texas |
| Authorized Official Name and Position | Angie Mattingly (MANAGER PROVIDER ENROLLMENT) |
| Authorized Official Contact | 5023813579 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Behavioral Support & Nursing Services, Llc 805 N Whittington Pkwy Louisville KY 40222-5186 Ph: (502) 394-2100 | Behavioral Support & Nursing Services, Llc 1600 Ne Loop 410 Ste 105 San Antonio TX 78209-1612 Ph: (210) 246-2334 |
| NPI Number | 1235768250 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/12/2022 |
| Certification Date | 04/12/2022 |
| Medicare PECOS PAC ID | 0941539886 |
|---|---|
| Medicare Enrollment ID | O20210125001822 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235768250 | NPI | - | NPPES |
| Provider Name | Matthew T Randel |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1114393139 PECOS PAC ID: 5193033389 Enrollment ID: I20151008001119 |
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