Provider Demographics
NPI:1568452365
Name:MONUMENT REHABILITATION AND NURSING CENTER, LLP
Entity Type:Organization
Organization Name:MONUMENT REHABILITATION AND NURSING CENTER, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:K
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:LFA
Authorized Official - Phone:979-968-3144
Mailing Address - Street 1:120 STATE LOOP 92
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE
Mailing Address - State:TX
Mailing Address - Zip Code:78945-6035
Mailing Address - Country:US
Mailing Address - Phone:979-968-3144
Mailing Address - Fax:979-968-6610
Practice Address - Street 1:120 STATE LOOP 92
Practice Address - Street 2:
Practice Address - City:LA GRANGE
Practice Address - State:TX
Practice Address - Zip Code:78945-6035
Practice Address - Country:US
Practice Address - Phone:979-968-3144
Practice Address - Fax:979-968-6610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-24
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX455715Medicare ID - Type UnspecifiedPROVIDER NUMBER