Organization
PENAN PARTNERSHIP
Active
Other names
Pebble Creek Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL PERKINS LNFA (ADMINISTRATOR)
(915) 857-0071
Entity
Organization
Contact information
Practice address
11608 SCOTT SIMPSON DR, EL PASO, TX 79936-6210
(915) 857-0071
(915) 857-0118
Mailing address
11608 SCOTT SIMPSON DR, EL PASO, TX 79936-6210
(915) 857-0071
(915) 857-0118
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
109836
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5239
—
TX
Enumeration date
07/01/2005
Last updated
04/25/2012
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