Stockdale TX SNF Management LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

STOCKDALE TX SNF MANAGEMENT LLC

Doing business as

Stockdale Residence and Rehabilitation Center

Practice address

300 W Salmon St
Stockdale, TX 78160-5907

Phone

(830) 996-3721

NPI assigned

May 29, 2013

Last updated

Jun 6, 2013By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Elie Deitsch

Title

Manager

Phone

(718) 747-8077

Specialties & licenses 1

Addresses

Other names 1

• Stockdale Residence and Rehabilitation Center Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1369785600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1370476800000",
    "number": "1215374491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W SALMON ST",
            "city": "STOCKDALE",
            "state": "TX",
            "postal_code": "781605907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W SALMON ST",
            "city": "STOCKDALE",
            "state": "TX",
            "postal_code": "781605907",
            "telephone_number": "830-996-3721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STOCKDALE TX SNF MANAGEMENT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-29",
        "last_updated": "2013-06-06",
        "status": "A",
        "authorized_official_last_name": "DEITSCH",
        "authorized_official_first_name": "ELIE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "718-747-8077",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Stockdale Residence and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Hillhaven Hollow PLLC
• Cecelia A Kothmann, FNP
• Tara Kvanvig-Garza, LPC
• Small Town Medical Solutions LLC
• Stockdale Isd
• Stockdale Volunteer Ambulance Service
• Miranda Keri Velasquez, LMFT, LCDC
• Tiffany Jo Williams, RN
• Wilson County Emergency Services District 3
• Mandy R Wright, FNP

• Skilled Nursing Facility in Stockdale, TX
• Providers in Stockdale, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.