Healthcare Provider Details
I. General information
NPI: 1144025198
Provider Name (Legal Business Name): S EL PASO OPERATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/14/2025
Last Update Date: 02/14/2025
Certification Date: 02/14/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
14300 PEBBLE HILLS BLVD
EL PASO TX
79938-2467
US
IV. Provider business mailing address
1040 CROWN POINTE PKWY STE 600
ATLANTA GA
30338-4741
US
V. Phone/Fax
- Phone: 915-955-9998
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CRAIG
ROBINSON
Title or Position: AUTHORIZED REPRESENTATIVE
Credential:
Phone: 770-698-9040