MALLKU, LLC (NPI# 1407149545) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407149545 |
| Entity Type | Organization |
| Organization Name | MALLKU, LLC |
| Practice Address |
28 Mondavi San Antonio TX 78258-4670 |
| Practice Telephone | 2103872599 |
| Mailing Telephone | 2103872599 |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2011-05-23 |
| Authorized Official Name | ENRIQUE LIRA (OWNER) |
| Authorized Official Telephone | 2103872599 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 320600000X | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | TX | Residential Treatment Facilities | |
| N | 320700000X | Residential Treatment Facility, Physical Disabilities | TX | Residential Treatment Facilities | |
| N | 320800000X | Community Based Residential Treatment Facility, Mental Illness | TX | Residential Treatment Facilities | |
| N | 323P00000X | Psychiatric Residential Treatment Facility | TX | Residential Treatment Facilities | |
| N | 324500000X | Substance Abuse Rehabilitation Facility | TX | Residential Treatment Facilities | |
| N | 3245S0500X |
Substance Abuse Rehabilitation Facility Specialization: Substance Abuse Treatment, Children |
TX | Residential Treatment Facilities | |
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | TX | Residential Treatment Facilities |
| Street Address |
28 MONDAVI |
| City | SAN ANTONIO |
| State | TX |
| Zip Code | 78258-4670 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356980163 | Jeffrey M. Martinez, M.d., P.a. | Surgery | 525 Centre Oak Drive, Suite 140, San Antonio, TX 78258 | 2019-12-26 |
| 1588226211 | New Life Brace and Limb, LLC | Prosthetist | 300 E. Sonterra Blvd., Suite 220, San Antonio, TX 78258 | 2019-07-02 |
| 1720649080 | Miguel Ibarra | Pharmacist | 18866 Stone Oak Pkwy., St.101, San Antonio, TX 78258 | 2019-06-26 |
| 1528538113 | Kevin Scott Farnsworth | Dentist | 1130 E. Sonterra Blvd Suite 100, San Antonio, TX 78258 | 2018-11-27 |
| 1891262176 | Dentists of Stone Oak, PC | Dentist | 23714 Hardy Oak Blvd, Suite 110, San Antonio, TX 78258 | 2018-10-25 |
| 1003399437 | Jesus Alcala | Physical Therapist | 20821 Us Hwy 281 N, Ste 110, San Antonio, TX 78258 | 2018-09-11 |
| 1184106544 | Marissa Kaye Bruton | Occupational Therapist | 505 Madison Oak, San Antonio, TX 78258 | 2018-09-02 |
| 1508346933 | Desiree Carroll | Occupational Therapy Assistant | 18803 Hardy Oak Drive, San Antonio, TX 78258 | 2018-08-15 |
| 1700376456 | Conner Jay Mcnabb | Optometrist | 810 Knights Cross Dr Ste 101, San Antonio, TX 78258 | 2018-05-17 |
| 1982191516 | Freehand Solutions LLC | Chiropractor | Nec Stone Oak Parkway & Loop 1604, San Antonio, TX 78258 | 2018-04-19 |
| Find all providers in zip 78258 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457999849 | Eri Industries, LLC, Dba Eri Group Homes | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2300 W. Commerce#216, San Antonio, TX 78207 | 2019-12-16 |
| 1538719463 | Agape 4 You,llc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 9122 Bowen Br, San Antonio, TX 78254-1914 | 2019-09-12 |
| 1811468960 | Integrity Healthcare Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8815 Burgandy, San Antonio, TX 78240-3529 | 2018-12-16 |
| 1083185607 | Lovinglyhome LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 12419 Horse Cres, San Antonio, TX 78254-6087 | 2018-12-07 |
| 1396229456 | Supported Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 18911 Hardy Oak Blvd Ste 164, San Antonio, TX 78258-4967 | 2018-09-24 |
| 1821580481 | Mi Amor Home & Community Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8151 Broadway St, San Antonio, TX 78209-1995 | 2018-05-30 |
| 1568983385 | Enchantment Living Hhc LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5927 Iris Isle, San Antonio, TX 78218-3091 | 2017-07-01 |
| 1871037135 | Glen Oaks Health Care Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 5822 Royal Hvn, San Antonio, TX 78239-1407 | 2016-12-06 |
| 1174978548 | Great Life Services, LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 6534 Candlecane Cir, San Antonio, TX 78244-1914 | 2016-05-04 |
| 1528435880 | Come Home - Victor's House | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2522 Hollyhill Dr, San Antonio, TX 78222-1352 | 2015-08-21 |
| Find all providers in SAN ANTONIO | ||||
| City | SAN ANTONIO |
| Zip Code | 78258 |
Please comment or provide details below to improve the information on MALLKU, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.