Providence Park Rehabilitation And Skilled Nursing
LBN: South Limestone Hospital District
Providence Park Rehabilitation And Skilled Nursing is an health care organization with primary practice located at 5505 New Copeland Rd , Tyler TX 75703-3955. The organization recently has only one registered license in Nursing & Custodial Care Facilities / Skilled Nursing Facility, which is considered as the primary health care specialty.
South Limestone Hospital District can be contacted via phone (903) 939-2443, or through Price, Larry N. via phone (254) 729-3281.
Contact Information
Primary practice address
5505 New Copeland Rd
Tyler TX 75703-3955
Phone: (903) 939-2443
Fax: (903) 939-2479
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing & Custodial Care Facilities / Skilled Nursing Facility | 314000000X | 124617 | Texas |
Profile Details
| NPI number | 1770752172 |
|---|---|
| LBN Legal business name | South Limestone Hospital District |
| DBA Doing business as | Providence Park Rehabilitation And Skilled Nursing |
| Authorized official | Price, Larry N. |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 29th, 2008 |
| Last updated | Apr 6th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1770752172 | NPPES |
| Texas | MEDICAID | 001021325 | |
| Texas | Other | 197010501 |
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