NPI 1174971865

Genuine Queens Jcl Care

Organisation PACE Provider Organization San Antonio, TX

Practice location

Address: 3730 S Loop 1604 E, San Antonio, TX 78264-9551
Phone: (210) 649-5653
Mailing address: PO Box 10306, San Antonio, TX 78210-0306

Authorised official

Name: Lkiendria Trischuan Johnson
Title: Owner
Phone: (210) 649-5653

Registered specialties

PACE Provider Organization Primary

Agencies Taxonomy 251T00000X

Other Program of All-Inclusive Care for the Elderly (PACE) Provider Organization providers in Texas →

Registry record

NPI: 1174971865
Entity type: Organization
NPI issued: 3 Jun 2016
Record last updated: 3 Jun 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.