Provider Demographics
NPI:1902043623
Name:MT. CARMEL HOME
Entity Type:Organization
Organization Name:MT. CARMEL HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SISTER.
Authorized Official - Middle Name:M
Authorized Official - Last Name:MICHELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-855-6243
Mailing Address - Street 1:4130 S. ALAMEDA STREET
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-1529
Mailing Address - Country:US
Mailing Address - Phone:361-855-6243
Mailing Address - Fax:361-855-0730
Practice Address - Street 1:4130 S. ALAMEDA STREET
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-1529
Practice Address - Country:US
Practice Address - Phone:361-855-6243
Practice Address - Fax:361-855-0730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-16
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness