Genuine Queens Jcl Care

NPI #1174971865 in San Antonio, Texas

Provider Information

NPI Number: 1174971865
Entity Type: Organization
Organization Name: Genuine Queens Jcl Care
Primary Specialty: Program of All-Inclusive Care for the Elderly (PACE) Provider Organization
Enumeration Date: Jun 3, 2016
Last Updated: Jun 3, 2016

Practice Location

Address: 3730 S LOOP 1604 E
City: San Antonio
State: Texas
ZIP Code: 78264-9551
Phone: (210) 649-5653

Authorized Official

Name: MISS LKIENDRIA TRISCHUAN JOHNSON
Title: OWNER
Phone: (210) 649-5653

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Program of All-Inclusive Care for the Elderly (PACE) Provider Organization	251T00000X	Primary

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