NPIMap

Organization Active NPI

Deer Park Nursing and Rehab Center LLC

Doing business as San Jacinto Manor

  • Skilled Nursing Facility
  • Deer Park, TX
National Provider Identifier
1376202234
Registry record updated May 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DEER PARK NURSING AND REHAB CENTER LLC
Doing business as
San Jacinto Manor
Practice address
206 W P St
Deer Park, TX 77536-4802
Phone
(801) 601-1450
NPI assigned
Dec 8, 2021
Last updated
May 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2022

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

Authorized official

Name
Dustin Monroe
Title
General Counsel
Phone
(385) 240-6408

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

206 W P St
Deer Park, TX 77536-4802

Mailing address

206 W P St
Deer Park, TX 77536-4802
Phone (281) 479-8471

Other names 1

  • San Jacinto Manor Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maverick County HSP ER15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1638921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652313600000",
    "number": "1376202234",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 W P ST",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775364802",
            "telephone_number": "281-479-8471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 W P ST",
            "city": "DEER PARK",
            "state": "TX",
            "postal_code": "775364802",
            "telephone_number": "801-601-1450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK NURSING AND REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-08",
        "last_updated": "2022-05-12",
        "certification_date": "2022-05-12",
        "status": "A",
        "authorized_official_last_name": "MONROE",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "385-240-6408"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Jacinto Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Deer Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2022; 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.