# SAN JUAN NURSING HOME, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619918489
- **Authorized official:** ELOISA FERNANDEZ (ADMINISTRATOR)
- **Authorized official phone:** (956) 787-1771

## Contact information

- **Practice address:** 300 N NEBRASKA AVE, SAN JUAN, TX 78589-3040
- **Practice address phone:** (956) 787-1771
- **Practice address fax:** (956) 787-8091
- **Mailing address:** 300 N. NEBRASKA AVE., SAN JUAN, TX 78589
- **Mailing address phone:** (956) 787-1771
- **Mailing address fax:** (956) 787-8091

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 144386 | TX | Yes |

## Other

- **Enumeration date:** 06/10/2006
- **Last updated:** 12/22/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000454002 | — | TX |
| 01 | — | 144386 | TEXAS DEPARTMENT OF AGING AND DISABILITIES | TX |
| 01 | — | 45D0665204 | CLIA | TX |