Provider Demographics
NPI:1457551749
Name:MAHARLIKA RESOURCES, INC.
Entity Type:Organization
Organization Name:MAHARLIKA RESOURCES, INC.
Other - Org Name:DBA: MOUNTAIN VILLA AT KERRVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DIONICIO
Authorized Official - Middle Name:R
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-329-1039
Mailing Address - Street 1:11913 PASEO DORADO CIR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-3785
Mailing Address - Country:US
Mailing Address - Phone:915-329-1039
Mailing Address - Fax:866-838-4666
Practice Address - Street 1:2201 JUNCTION HWY
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-9392
Practice Address - Country:US
Practice Address - Phone:830-792-4001
Practice Address - Fax:866-838-4666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-24
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102640310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102640OtherASSISTED LIVING FACILITY