Healthcare Provider Details

I. General information

NPI: 1720464563
Provider Name (Legal Business Name): GRUENEPOINTE 1 MT. PLEASANT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 09/01/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2530 GREENHILL RD
MT PLEASANT TX
75455-6744
US

IV. Provider business mailing address

8502 HUEBNER RD STE 400
SAN ANTONIO TX
78240-2466
US

V. Phone/Fax

Practice location:
  • Phone: 903-572-0974
  • Fax:
Mailing address:
  • Phone: 210-757-4987
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. KURT DULLNIG
Title or Position: VICE PRESIDENT
Credential:
Phone: 210-757-4987