# ROCKPORT COASTAL CARE CENTER, INC.

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

## Provider details

- **NPI number:** 1619988904
- **Authorized official:** MR. BRADLEY S. MCDONALD LNHA (ADMINISTRATOR/OWNER)
- **Authorized official phone:** (361) 729-1228

## Contact information

- **Practice address:** 1004 S YOUNG ST, ROCKPORT, TX 78382-3933
- **Practice address phone:** (361) 729-1228
- **Practice address fax:** (361) 729-1299
- **Mailing address:** 1004 S YOUNG ST, ROCKPORT, TX 78382-3933
- **Mailing address phone:** (361) 729-1228
- **Mailing address fax:** (361) 729-1299

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 110464 | TX | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 06/24/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001001322 | — | TX |
| 05 | — | 5200 | — | TX |