Provider Demographics
NPI:1619474921
Name:CORPUS NURSING AND REHABILITATION, LP
Entity Type:Organization
Organization Name:CORPUS NURSING AND REHABILITATION, LP
Other - Org Name:VISTA DEL MAR HEALTH & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FLAGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-387-4388
Mailing Address - Street 1:419 S ELM ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-6085
Mailing Address - Country:US
Mailing Address - Phone:940-387-4388
Mailing Address - Fax:940-380-2410
Practice Address - Street 1:1314 3RD ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2208
Practice Address - Country:US
Practice Address - Phone:361-888-5511
Practice Address - Fax:361-888-4514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility