Shady Shores of Refugio LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SHADY SHORES OF REFUGIO LLC

Practice address

201 Swift St
Refugio, TX 78377-2428

Phone

(361) 526-4641

NPI assigned

Jul 29, 2015

Organization subpart

No

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

Authorized official

Name

Michael Wallace

Title

Ceo

Phone

(214) 422-1622

Specialties & licenses 1

Addresses

Other names 1

• Refugio Nursing & Rehab Center Doing business as

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

{
    "created_epoch": "1438128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465862400000",
    "number": "1922483064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAGLE DR",
            "address_2": "SUITE 201",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762016898",
            "telephone_number": "940-228-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 SWIFT ST",
            "city": "REFUGIO",
            "state": "TX",
            "postal_code": "783772428",
            "telephone_number": "361-526-4641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY SHORES OF REFUGIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-29",
        "last_updated": "2016-06-14",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-422-1622"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Refugio Nursing & Rehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Refugio Management, Inc
• Refugio Nursing and Rehabilitation, LP
• Jennifer Richardson, PHARMD
• Clarissa Rosas
• Joseph Rose, PT
• Shelly Singleton, P.A.
• Debra Kay Staples, RN, NP-C (FNP)
• Charles Arthur Watts, DDS
• Catherine Marie White, RDH
• Woodsboro Pharmacy Inc

• Skilled Nursing Facility in Refugio, TX
• Providers in Refugio, 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 Jun 14, 2016; 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.