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General NPI Number Information
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NPI Number | 1245224054
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Entity Type | Organization
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Legal Business Name | MERIDIAN ROCKPORT ALF, LP
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Dates
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Enumeration Date | 09/07/2005
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 900 ENTERPRISE BLVD
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City | ROCKPORT
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State | TX
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Zip | 78382
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Country | US
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Telephone | 361-729-5254
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Fax | 361-729-3820
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Provider Business Mailing Address
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Address Line | 2828 N. HARWOOD SUITE 1100
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City | DALLAS
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State | TX
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Zip | 75201-1512
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Country | US
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Telephone | 214-252-7600
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Fax | 214-252-7704
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Authorized Official
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Title or Position | PRESIDENT
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Name | DAVID RONCK
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Credential |
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Telephone | 214-651-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 113898
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 129349
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License Number State | TX
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