1295902203 NPI number — REGENCY NURSING CENTER PARTNERS OF HARLINGEN, LTD.

Table of content: (NPI 1295902203)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295902203 NPI number — REGENCY NURSING CENTER PARTNERS OF HARLINGEN, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGENCY NURSING CENTER PARTNERS OF HARLINGEN, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HARLINGEN NURSING AND REHABILITATION CENTER
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295902203
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 W GOODWIN AVE
Provider Second Line Business Mailing Address:
STE 600
Provider Business Mailing Address City Name:
VICTORIA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77901-6502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-576-0694
Provider Business Mailing Address Fax Number:
361-576-5484

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3810 HALE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARLINGEN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78550-9230
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
956-412-8660
Provider Business Practice Location Address Fax Number:
956-412-8687
Provider Enumeration Date:
05/09/2008

Additional Information

Authorized Official

Authorized Official Last Name:
LACERDA
Authorized Official First Name:
HEBER
Authorized Official Middle Name:
S
Authorized Official Title or Position:
VICE PRESIDENT/CEO
Authorized Official Telephone Number:
361-576-0694

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 011175901 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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