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Organization

PM MANAGEMENT - GOLDEN TRIANGLE NC III LLC

Active
Other names
Cypress Glen
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization

Contact information

Practice address
7200 9TH AVE, PORT ARTHUR, TX 77642-6405
(409) 729-8701
(409) 729-5722
Mailing address
600 N PEARL ST STE 1050, DALLAS, TX 75201-7495
(214) 252-7600
(214) 252-7704

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
131482
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001019215
TX
01
050720
FACILITY ID
TX
Enumeration date
12/02/2010
Last updated
03/03/2020
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