Organization
ROCKPORT COASTAL CARE CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRADLEY S. MCDONALD LNHA (ADMINISTRATOR/OWNER)
(361) 729-1228
Entity
Organization
Contact information
Practice address
1004 S YOUNG ST, ROCKPORT, TX 78382-3933
(361) 729-1228
(361) 729-1299
Mailing address
1004 S YOUNG ST, ROCKPORT, TX 78382-3933
(361) 729-1228
(361) 729-1299
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001001322
—
TX
05
—
5200
—
TX
Enumeration date
08/11/2006
Last updated
06/24/2015
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