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Organization
GREENVILLE NURSING CENTER, L.P.
Active
Organization
GREENVILLE NURSING CENTER, L.P.
Active
Other names
Greenville Health & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (PRESIDENT OF GENERAL PARTNER)
(215) 441-7700
Entity
Organization
Contact information
Practice address
4910 WELLINGTON ST., GREENVILLE, TX 75402-6007
(903) 454-3772
(903) 454-3881
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025-1048
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
108484
TX
332BN1400X
Nursing Facility Supplies (DME)
115334
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
115334
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004188
—
TX
05
—
005107
—
TX
05
—
153004001
—
TX
05
—
153004002
—
TX
05
—
153004003
—
TX
Enumeration date
10/25/2005
Last updated
05/29/2009
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