Provider Demographics
NPI:1912372459
Name:ROCKDALE SNF LLC
Entity Type:Organization
Organization Name:ROCKDALE SNF LLC
Other - Org Name:ROCKDALE ESTATES AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAURIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KUNKA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-399-6788
Mailing Address - Street 1:6500 HORIZON CIR
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-6985
Mailing Address - Country:US
Mailing Address - Phone:254-399-6788
Mailing Address - Fax:
Practice Address - Street 1:1350 W US HIGHWAY 79
Practice Address - Street 2:
Practice Address - City:ROCKDALE
Practice Address - State:TX
Practice Address - Zip Code:76567
Practice Address - Country:US
Practice Address - Phone:512-446-2548
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility