Healthcare Provider Details

I. General information

NPI: 1285962803
Provider Name (Legal Business Name): GANADO NURSING AND REHABILITATION CENTER. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2009
Last Update Date: 11/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 E ROGERS ST
GANADO TX
77962-8420
US

IV. Provider business mailing address

115 MEDICAL DR SUITE 200
VICTORIA TX
77904-3102
US

V. Phone/Fax

Practice location:
  • Phone: 361-771-3315
  • Fax:
Mailing address:
  • Phone: 361-576-9454
  • Fax: 361-576-2994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. BYRON M BURRIS II
Title or Position: PRESIDENT
Credential:
Phone: 361-576-0197