| NPI | 1316002165 |
|---|---|
| Former Legal Business Name | SUSAN RESIDENTIAL SERVICES |
| Entity Type | Organization |
| Authorized Contact | SUSAN FREDERICK President/CEO 210-360-9982 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2019-06-06 |