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Organization
MOUNT VERNON HEALTHCARE RESIDENCE LLC
Active
Organization
MOUNT VERNON HEALTHCARE RESIDENCE LLC
Active
Other names
Mission Manor Healthcare Residence
Organization subpart
No
Provider details
NPI number
Authorized official
JOE NEUMAN (CHIEF EXECUTIVE OFFICER)
(214) 396-3462
Entity
Organization
Contact information
Practice address
501 YATES ST, MOUNT VERNON, TX 75457-3233
(214) 396-3462
Mailing address
111 CLIFTON AVE STE 12, LAKEWOOD, NJ 08701-3342
(214) 396-3462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
004659
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026912
—
TX
Enumeration date
11/28/2014
Last updated
06/20/2016
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