Healthcare Provider Details

I. General information

NPI: 1194954784
Provider Name (Legal Business Name): THE VILLAS OF MOUNT PLEASANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 04/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 GREENHILL ROAD
MOUNT PLEASANT TX
75455-6744
US

IV. Provider business mailing address

2530 GREENHILL ROAD
MOUNT PLEASANT TX
75455-6744
US

V. Phone/Fax

Practice location:
  • Phone: 817-303-4089
  • Fax:
Mailing address:
  • Phone: 817-303-4089
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number128706
License Number StateTX

VIII. Authorized Official

Name: SHAWN CONLEY
Title or Position: CFO
Credential:
Phone: 817-303-4089