NPI 1174023063

Nicole Jefferson

Practitioner Physical Disabilities Residential Treatment Facility Seguin, TX

Practice location

Address: 529 Grayson Ln, Seguin, TX 78155-3084
Phone: (254) 289-4071
Fax: (830) 433-4219

Registered specialties (6)

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X

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Assisted Living Facility (Mental Illness)

Nursing & Custodial Care Facilities Taxonomy 3104A0625X

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Adult Care Home Facility

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

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Mental Illness Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320800000X

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Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320900000X

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Adult Day Care Clinic/Center

Ambulatory Health Care Facilities Taxonomy 261QA0600X

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Registry record

NPI: 1174023063
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Feb 2018
Record last updated: 13 Aug 2023

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.