IndividualActive
Nicole Jefferson
NPI 1174023063 · Physical Disabilities Residential Treatment Facility · Seguin, TX
Provider details
- NPI number
- 1174023063
- Entity type
- Individual
- Primary specialty
- Physical Disabilities Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Residential Treatment Facilities
Nursing & Custodial Care Facilities
- Adult Care Home Facility311ZA0620X
Nursing & Custodial Care Facilities
Residential Treatment Facilities
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility320900000X
Residential Treatment Facilities
- Adult Day Care Clinic/Center261QA0600X
Ambulatory Health Care Facilities
Practice location
529 Grayson Ln
Seguin, TX 78155-3084
Phone: (254) 289-4071
Fax: (830) 433-4219
Approximate (ZIP-level) locationGet directions
Mailing address
529 Grayson Ln
Seguin, TX 78155-3084
Registry dates
- Enumerated
- 2018-02-16
- Last updated
- 2023-08-13
- Certified
- 2023-08-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.