Provider Demographics
NPI:1881685881
Name:GUADALUPE VALLEY NURSING CENTER,LP
Entity Type:Organization
Organization Name:GUADALUPE VALLEY NURSING CENTER,LP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NEUMANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-379-9308
Mailing Address - Street 1:1210 EASTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5134
Mailing Address - Country:US
Mailing Address - Phone:830-379-9308
Mailing Address - Fax:830-379-0703
Practice Address - Street 1:1210 EASTWOOD DR
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5134
Practice Address - Country:US
Practice Address - Phone:830-379-9308
Practice Address - Fax:830-379-0703
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-31
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
TX455869Medicare ID - Type Unspecified