Provider Demographics
NPI:1952305724
Name:FE DEERE INC
Entity Type:Organization
Organization Name:FE DEERE INC
Other - Org Name:RIVER RIDGE NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEERE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-991-9021
Mailing Address - Street 1:4838 HOLLY ROAD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4753
Mailing Address - Country:US
Mailing Address - Phone:361-991-7021
Mailing Address - Fax:361-991-9162
Practice Address - Street 1:3922 W RIVER DR
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78410-5725
Practice Address - Country:US
Practice Address - Phone:361-767-2000
Practice Address - Fax:361-767-2006
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:F.E. DEERE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2005-06-09
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114209313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005351Medicaid
TX005351Medicaid