# LAREDO OPERATOR LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Laredo Nursing Rehabilition Ctr
- **Organization subpart:** No

## Provider details

- **NPI number:** 1780966143
- **Authorized official:** MR. CARL FELLBAUM (CEO)
- **Authorized official phone:** (210) 828-5686

## Contact information

- **Practice address:** 1701 TOURNAMENT TRAIL DRIVE, LAREDO, TX 78041
- **Practice address phone:** (210) 828-5686
- **Practice address fax:** (210) 798-0725
- **Mailing address:** 1020 NE LOOP 410, SUITE 640, SAN ANTONIO, TX 78209-1204
- **Mailing address phone:** (210) 828-5686
- **Mailing address fax:** (210) 798-0725

## Taxonomy

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

## Other

- **Enumeration date:** 09/12/2011
- **Last updated:** 01/09/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001020466 | — | TX |