Convacare Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

109037 Issued in TX

Legal business name

CONVACARE INC

Doing business as

Mi Casita Care Center

Practice address

2400 Quaker Ave
Lubbock, TX 79410-1834

Phone

(806) 792-2831

Fax

(806) 792-5023

NPI assigned

May 23, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Richard Ruble

Title

President

Phone

(806) 780-7000

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Mi Casita Care Center Doing business as

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1639172877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101834",
            "telephone_number": "806-792-2831",
            "fax_number": "806-792-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 QUAKER AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101834",
            "telephone_number": "806-792-2831",
            "fax_number": "806-792-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVACARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-05-23",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "RUBLE",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "806-780-7000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "109037",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171177201",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4491",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001001028",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mi Casita Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Consultants in Infectious Diseases
• Consultants in Infectious Diseases
• Edwin A Contreras, M.D PA.
• Haylee Contreras, PHARM. D.
• Justin Manuel Contreras, PHARMD
• Convacare Inc
• Dawn Conwright, CPNP
• Cook Children'S Physician Network
• Caleb John Cook, M.D.
• Corey Rynn Cook, PHARMD

• Skilled Nursing Facility in Lubbock, TX
• Providers in Lubbock, 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 Apr 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.