Organization
BLUEBONNET OPERATIONS NURSING CENTER, L.P.
Active
Other names
Bluebonet Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (PRESIDENT OF GENERAL PARTNER)
(215) 441-7700
Entity
Organization
Contact information
Practice address
724 S. BAIRD HWY 283, ALBANY, TX 76430-0608
(325) 762-3329
(325) 762-2871
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115288
TX
332BN1400X
Nursing Facility Supplies (DME)
115288
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
115288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004323
—
TX
Enumeration date
10/12/2005
Last updated
11/14/2007
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