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Organization
PALO PINTO NURSING CENTER, L.P.
Active
Organization
PALO PINTO NURSING CENTER, L.P.
Active
Other names
Palo Pinto Nursing 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
200 SW 25TH AVE, MINERAL WELLS, TX 76067-8242
(940) 325-7813
(940) 325-5680
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
108630
TX
332BN1400X
Nursing Facility Supplies (DME)
121109
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
121109
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004735
—
TX
Enumeration date
10/26/2005
Last updated
10/29/2007
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