# MAHARLIKA DYNASTY, LLC

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

## Provider details

- **NPI number:** 1902123482
- **Authorized official:** DONOVAN J RIVERA (MANAGING MEMBER)
- **Authorized official phone:** (915) 227-9172

## Contact information

- **Practice address:** 2729 PORTER AVE, EL PASO, TX 79930-3625
- **Practice address phone:** (915) 566-2111
- **Practice address fax:** (915) 562-6611
- **Mailing address:** 11913 PASEO DORADO CIR, EL PASO, TX 79936-3785
- **Mailing address phone:** (915) 227-9172

## Taxonomy

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

## Other

- **Enumeration date:** 04/23/2010
- **Last updated:** 04/23/2010