Organization
SOUTHEAST NURSING & REHABILITATION CENTER, L.P.
Active
Other names
Southeast Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PETER J LICARI (PRESIDENT OF GENERAL PARTNER)
(215) 441-7700
Entity
Organization
Contact information
Practice address
4302 E. SOUTHCROSS BLVD., SAN ANTONIO, TX 78222
(210) 333-1223
(210) 333-2134
Mailing address
200 DRYDEN ROAD, SUITE 2000, DRESHER, PA 19025-1048
(215) 441-7700
(215) 441-4255
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115121
TX
332BN1400X
Nursing Facility Supplies (DME)
115121
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
115121
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005076
—
TX
Enumeration date
05/08/2006
Last updated
10/30/2007
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