Mesquite Nursing Center, L.P.

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

108463 Issued in TX

Legal business name

MESQUITE NURSING CENTER, L.P.

Doing business as

Mesquite Tree Nursing Center

Practice address

434 Paza Drive
Mesquite, TX 75149-5198

Phone

(972) 288-6489

Fax

(972) 216-1791

NPI assigned

Oct 25, 2005

Last updated

Oct 29, 2007By 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. Peter J Licari

Title

President of General Partner

Phone

(215) 441-7700

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Mesquite Tree Nursing Center Doing business as

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1780674267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 DRYDEN ROAD",
            "address_2": "SUITE 2000",
            "city": "DRESHER",
            "state": "PA",
            "postal_code": "190251048",
            "telephone_number": "215-441-7700",
            "fax_number": "215-441-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "434 PAZA DRIVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751495198",
            "telephone_number": "972-288-6489",
            "fax_number": "972-216-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESQUITE NURSING CENTER, L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "LICARI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT OF GENERAL PARTNER",
        "authorized_official_telephone_number": "215-441-7700",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "108463",
            "primary": true
        },
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility Supplies",
            "state": "TX",
            "license": "115460",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "TX",
            "license": "115460",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005055",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mesquite Tree Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Mesquite, TX
• Providers in Mesquite, 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 Oct 29, 2007; 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.