Healthcare Provider Details

I. General information

NPI: 1063784924
Provider Name (Legal Business Name): REGAL SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2012
Last Update Date: 02/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 E AVENUE J
LAMPASAS TX
76550-1211
US

IV. Provider business mailing address

200 W HWY 6 STE 612
WACO TX
76712-3969
US

V. Phone/Fax

Practice location:
  • Phone: 512-556-6267
  • Fax: 512-556-6601
Mailing address:
  • Phone: 254-399-6788
  • Fax: 254-399-6766

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: JOSEPH A. NEAL
Title or Position: MANAGER
Credential:
Phone: 25439967888