Provider Demographics
NPI: | 1184784324 |
---|---|
Name: | RAMIREZ RESIDENTIAL CARE HOME |
Entity type: | Organization |
Organization Name: | RAMIREZ RESIDENTIAL CARE HOME |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ROBERT |
Authorized Official - Middle Name: | BRENDEN |
Authorized Official - Last Name: | RAMIREZ |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 830-665-9725 |
Mailing Address - Street 1: | 1034 COUNTY ROAD 664 |
Mailing Address - Street 2: | |
Mailing Address - City: | DEVINE |
Mailing Address - State: | TX |
Mailing Address - Zip Code: | 78016-4628 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 830-665-9725 |
Mailing Address - Fax: | 830-665-2787 |
Practice Address - Street 1: | 1034 COUNTY ROAD 664 |
Practice Address - Street 2: | |
Practice Address - City: | DEVINE |
Practice Address - State: | TX |
Practice Address - Zip Code: | 78016-4628 |
Practice Address - Country: | US |
Practice Address - Phone: | 830-665-9725 |
Practice Address - Fax: | 830-665-2787 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-12-11 |
Last Update Date: | 2020-08-22 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
TX | 000604 | 310400000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |