Organization
SAN JUAN NURSING HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELOISA FERNANDEZ (ADMINISTRATOR)
(956) 787-1771
Entity
Organization
Contact information
Practice address
300 N NEBRASKA AVE, SAN JUAN, TX 78589-3040
(956) 787-1771
(956) 787-8091
Mailing address
300 N. NEBRASKA AVE., SAN JUAN, TX 78589
(956) 787-1771
(956) 787-8091
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
144386
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000454002
—
TX
01
—
144386
TEXAS DEPARTMENT OF AGING AND DISABILITIES
TX
01
—
45D0665204
CLIA
TX
Enumeration date
06/10/2006
Last updated
12/22/2021
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