Organization
REGENCY IHS OF MAVERICK LLC
Active
Other names
Maverick Nursing and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DONOVAN R DEKOWSKI (CFO)
(361) 576-0694
Entity
Organization
Contact information
Practice address
3106 BOB ROGERS DR, EAGLE PASS, TX 78852-6302
(830) 757-8566
(830) 773-7496
Mailing address
3106 BOB ROGERS DR, EAGLE PASS, TX 78852-6302
(830) 757-8566
(830) 773-7496
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5499
—
TX
Enumeration date
06/12/2018
Last updated
06/12/2018
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