Organization
SOUTHWEST LTC - CORPUS, LLC
Active
Other names
Harbor View Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD R PAYNE (CEO)
(469) 916-6100
Entity
Organization
Contact information
Practice address
1314 3RD ST, CORPUS CHRISTI, TX 78404-2208
(469) 916-6100
(469) 916-6105
Mailing address
1518 LEGACY DR, SUITE 110, FRISCO, TX 75034-6038
(469) 916-6100
(469) 916-6105
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
136295
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5114
—
TX
Enumeration date
12/17/2014
Last updated
06/02/2015
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