# CONVACARE INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mi Casita Care Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639172877
- **Authorized official:** MR. RICHARD RUBLE (PRESIDENT)
- **Authorized official phone:** (806) 780-7000

## Contact information

- **Practice address:** 2400 QUAKER AVE, LUBBOCK, TX 79410-1834
- **Practice address phone:** (806) 792-2831
- **Practice address fax:** (806) 792-5023
- **Mailing address:** 2400 QUAKER AVE, LUBBOCK, TX 79410-1834
- **Mailing address phone:** (806) 792-2831
- **Mailing address fax:** (806) 792-5023

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 109037 | TX | Yes |

## Other

- **Enumeration date:** 05/23/2005
- **Last updated:** 04/29/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001001028 | — | TX |
| 05 | — | 171177201 | — | TX |
| 05 | — | 4491 | — | TX |