Provider Demographics
NPI:1871627349
Name:LANGE AND FORD, INC.
Entity type:Organization
Organization Name:LANGE AND FORD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:KYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:210-494-1956
Mailing Address - Street 1:2002 PINETREE LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-4938
Mailing Address - Country:US
Mailing Address - Phone:210-494-1956
Mailing Address - Fax:210-494-1957
Practice Address - Street 1:2002 PINETREE LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-4938
Practice Address - Country:US
Practice Address - Phone:210-494-1956
Practice Address - Fax:210-494-1957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX115329315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities