Provider Demographics
NPI:1568640837
Name:EL PASO LTACH PARTNER, LP
Entity Type:Organization
Organization Name:EL PASO LTACH PARTNER, LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:EVELYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:STEWART
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:915-496-9688
Mailing Address - Street 1:1221 N COTTON ST
Mailing Address - Street 2:3RD FLR
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-3015
Mailing Address - Country:US
Mailing Address - Phone:915-496-9687
Mailing Address - Fax:915-496-9695
Practice Address - Street 1:1221 N COTTON ST
Practice Address - Street 2:3RD FLR
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3015
Practice Address - Country:US
Practice Address - Phone:915-496-9687
Practice Address - Fax:915-496-9695
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-08
Last Update Date:2008-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX841300282E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX670026OtherMEDICARE CCN