Organization
LA HACIENDA SCC LLC
Active
Other names
La Hacienda Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL BEAL (CHIEF EXECUTIVE OFFICER)
(214) 252-7600
Entity
Organization
Contact information
Practice address
3730 W OREM DR, HOUSTON, TX 77045-4426
(832) 799-6484
(832) 201-6952
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
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026540
—
TX
01
—
5625 105089
VENDOR ID/FACILITY ID
TX
Enumeration date
12/18/2014
Last updated
03/03/2020
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