| Evergreen Elder Care, Inc. | |
|
7340 Blanco Rd Suite 1122 San Antonio TX 78216-4966 | |
| (210) 826-2116 | |
| (210) 525-8979 |
| Full Name | Evergreen Elder Care, Inc. |
|---|---|
| Speciality | Psychologist |
| Location | 7340 Blanco Rd, San Antonio, Texas |
| Authorized Official Name and Position | James R Crawford (OWNER/DIRECTOR) |
| Authorized Official Contact | 2108262116 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evergreen Elder Care, Inc. 7340 Blanco Rd Suite 1122 San Antonio TX 78216-4966 Ph: (210) 826-2116 | Evergreen Elder Care, Inc. 7340 Blanco Rd Suite 1122 San Antonio TX 78216-4966 Ph: (210) 826-2116 |
| NPI Number | 1578658639 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 07/08/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578658639 | NPI | - | NPPES |
| 1728479-01 | Medicaid | TX | |
| 31420501578216-8001 | Other | TX | TRICARE GROUP NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| 104100000X | Social Worker | (* (Not Available)) | Secondary |
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Secondary |
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