# REGENCY IHS OF MAVERICK LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maverick Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396238580
- **Authorized official:** MR. DONOVAN R DEKOWSKI (CFO)
- **Authorized official phone:** (361) 576-0694

## Contact information

- **Practice address:** 3106 BOB ROGERS DR, EAGLE PASS, TX 78852-6302
- **Practice address phone:** (830) 757-8566
- **Practice address fax:** (830) 773-7496
- **Mailing address:** 3106 BOB ROGERS DR, EAGLE PASS, TX 78852-6302
- **Mailing address phone:** (830) 757-8566
- **Mailing address fax:** (830) 773-7496

## Taxonomy

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

## Other

- **Enumeration date:** 06/12/2018
- **Last updated:** 06/12/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5499 | — | TX |