Provider Demographics
NPI:1437261583
Name:REGENT CARE CENTER OF LEAGUE CITY, LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:REGENT CARE CENTER OF LEAGUE CITY, LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:PROF
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:J
Authorized Official - Last Name:OSTERMAYER
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:409-763-6000
Mailing Address - Street 1:2302 POST OFFICE ST
Mailing Address - Street 2:SUITE 402
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77550-1913
Mailing Address - Country:US
Mailing Address - Phone:409-763-6000
Mailing Address - Fax:409-770-0233
Practice Address - Street 1:2620 W WALKER ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-6812
Practice Address - Country:US
Practice Address - Phone:281-309-5400
Practice Address - Fax:281-309-5444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
TX6044520001332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001015296Medicaid
TX676153Medicare Oscar/Certification
TX6044520001Medicare NSC