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Organization

THREE RIVERS NURSING HOME, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RONALD L VIDRINE (OWNER)
(361) 786-2256
Entity
Organization

Contact information

Practice address
1717 45TH ST., THREE RIVERS, TX 78071-2649
(361) 786-2256
(361) 786-2456
Mailing address
1717 45TH ST., THREE RIVERS, TX 78071-2649
(361) 786-2256
(361) 786-2456

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
112944
TX
314000000X
Skilled Nursing Facility
131278
TX
314000000X
Skilled Nursing Facility
Primary
136010
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001012235
TX
Enumeration date
10/12/2006
Last updated
06/19/2013
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