Provider Demographics
NPI:1174658686
Name:VILLA QUILT OF HARLINGEN, LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:VILLA QUILT OF HARLINGEN, LIMITED PARTNERSHIP
Other - Org Name:VILLA OF HARLINGEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:WITT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:505-797-8735
Mailing Address - Street 1:105 AL CONWAY
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-1762
Mailing Address - Country:US
Mailing Address - Phone:956-425-7035
Mailing Address - Fax:956-425-6970
Practice Address - Street 1:105 AL CONWAY
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-1762
Practice Address - Country:US
Practice Address - Phone:956-425-7035
Practice Address - Fax:956-425-6970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000770310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility