# DEER PARK NURSING AND REHAB CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** San Jacinto Manor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376202234
- **Authorized official:** DUSTIN MONROE (GENERAL COUNSEL)
- **Authorized official phone:** (385) 240-6408

## Contact information

- **Practice address:** 206 W P ST, DEER PARK, TX 77536-4802
- **Practice address phone:** (801) 601-1450
- **Mailing address:** 206 W P ST, DEER PARK, TX 77536-4802
- **Mailing address phone:** (281) 479-8471

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | — | — | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 12/08/2021
- **Last updated:** 05/12/2022