Organization
LA HACIENDA NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES M BAKER JR. (ADMINISTRATOR)
(361) 279-3860
Entity
Organization
Contact information
Practice address
4410 HIGHWAY 44, SAN DIEGO, TX 78384-4516
(361) 279-3860
(361) 279-3687
Mailing address
4410 HIGHWAY 44, SAN DIEGO, TX 78384-4516
(361) 279-3860
(361) 279-3687
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
112118
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4578
—
TX
Enumeration date
09/26/2005
Last updated
08/22/2020
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