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Organization

REGENCY NURSING CENTER PARTNERS OF PORT LAVACA, LTD

Active
Other names
PORT LAVACA NURSING AND REHABILITATION CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MR. HEBER S. LACERDA (PRESIDENT/CEO)
(361) 576-0694
Entity
Organization

Contact information

Practice address
524 VILLAGE RD, PORT LAVACA, TX 77979-2380
(361) 552-3741
(361) 552-5808
Mailing address
524 VILLAGE RD, PORT LAVACA, TX 77979-2380
(361) 552-3741
(361) 552-5808

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
113221
TX
314000000X
Skilled Nursing Facility
Primary
455999
TX
332B00000X
Durable Medical Equipment & Medical Supplies
4142560001
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001001779
TX
05
142997902
TX
05
142997903
TX
05
425903
TX
01
HH044S
BCBS BLUELINK
TX
Enumeration date
04/13/2006
Last updated
07/01/2009
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