Organization
PM MANAGEMENT-BABCOCK NC LLC
Active
Other names
Mesa Vista Inn Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization
Contact information
Practice address
5756 N KNOLL, SAN ANTONIO, TX 78240-2238
(210) 321-5200
(210) 321-5297
Mailing address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7600
(214) 252-7704
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
125844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012308
—
TX
01
—
004754
FACILITY ID NO.
TX
Enumeration date
12/11/2006
Last updated
03/04/2020
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