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Organization Active NPI

Retama Manor del Rio LLC

Doing business as Retama Manor Del Rio

  • Skilled Nursing Facility
  • Del Rio, TX
National Provider Identifier
1598801631
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
RETAMA MANOR DEL RIO LLC
Doing business as
Retama Manor Del Rio
Practice address
100 Herrmann Dr
Del Rio, TX 78840-4125
Phone
(830) 775-7477
NPI assigned
Jan 29, 2007
Last updated
Jan 20, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

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

Authorized official

Name
Pedro Zamora
Title
President
Phone
(830) 775-7477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

100 Herrmann Dr
Del Rio, TX 78840-4125

Mailing address

930 Ridgebrook Rd
Sparks, MD 21152-9390

Other identifiers 1

IdentifierTypeStateIssuer
001014915MedicaidTX

Other names 1

  • Retama Manor Del Rio Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1598801631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HERRMANN DR",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788404125",
            "telephone_number": "830-775-7477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RETAMA MANOR DEL RIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "ZAMORA",
        "authorized_official_first_name": "PEDRO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "830-775-7477"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014915",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Retama Manor Del Rio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Del Rio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.