# MOUNT VERNON HEALTHCARE RESIDENCE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mission Manor Healthcare Residence
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346647898
- **Authorized official:** JOE NEUMAN (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (214) 396-3462

## Contact information

- **Practice address:** 501 YATES ST, MOUNT VERNON, TX 75457-3233
- **Practice address phone:** (214) 396-3462
- **Mailing address:** 111 CLIFTON AVE STE 12, LAKEWOOD, NJ 08701-3342
- **Mailing address phone:** (214) 396-3462

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 004659 | TX | Yes |

## Other

- **Enumeration date:** 11/28/2014
- **Last updated:** 06/20/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001026912 | — | TX |