Holiday Pines Nursing and Rehabilitation LP

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

115077 Issued in TX

Legal business name

HOLIDAY PINES NURSING AND REHABILITATION LP

Practice address

1201 Cardinal Dr
Woodville, TX 75979-5428

Phone

(409) 283-3397

Fax

(409) 283-7564

NPI assigned

Sep 27, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael A. Rich

Title

President

Phone

(940) 387-4388

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1127779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218412800000",
    "number": "1568458305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N ELM ST",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762014137",
            "telephone_number": "940-387-4388",
            "fax_number": "940-380-2410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 CARDINAL DR",
            "city": "WOODVILLE",
            "state": "TX",
            "postal_code": "759795428",
            "telephone_number": "409-283-3397",
            "fax_number": "409-283-7564"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLIDAY PINES NURSING AND REHABILITATION LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-27",
        "last_updated": "2008-08-11",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "940-387-4388",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "115077",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001004233",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP DME CROSS-OVER",
            "identifier": "094431603",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TMHP CROSS-OVER",
            "identifier": "155126901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawna Greninger, CMA
• Dorothy Jean Griffin, M.ED., LPC
• Lexi Hagans
• Sandi Hanks, LPC
• Kathleen Castilaw Harris, N.P.
• Homecare Solutions of East Texas, Inc.
• J & S Ambulance Service, Inc. (dogwood ems)
• Jacqueline a Corkin DC
• Jessalyn Nicole Jones, APRN
• Elizabeth Allison Kenesson

• Skilled Nursing Facility in Woodville, TX
• Providers in Woodville, 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 Aug 11, 2008; 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.