| Green Pastures Mental Care Pllc | |
|
4358 Lockhill Selma Rd Ste 307 Shavano Park TX 78249-4167 | |
| (210) 940-0540 | |
| Not Available |
| Full Name | Green Pastures Mental Care Pllc |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 4358 Lockhill Selma Rd Ste 307, Shavano Park, Texas |
| Authorized Official Name and Position | Sarah Casola (DIRECTOR) |
| Authorized Official Contact | 2109400540 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Green Pastures Mental Care Pllc 12370 Potranco Rd Ste 207 San Antonio TX 78253-4260 Ph: () - | Green Pastures Mental Care Pllc 4358 Lockhill Selma Rd Ste 307 Shavano Park TX 78249-4167 Ph: (210) 940-0540 |
| NPI Number | 1518679141 |
|---|---|
| Provider Enumeration Date | 12/14/2022 |
| Last Update Date | 02/13/2024 |
| Certification Date | 02/13/2024 |
| Medicare PECOS PAC ID | 3971948530 |
|---|---|
| Medicare Enrollment ID | O20240305002912 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518679141 | NPI | - | NPPES |
| Provider Name | Sarah Casola |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1275285520 PECOS PAC ID: 3678966801 Enrollment ID: I20220210000347 |
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