=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386623510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MOTHER OF PERPETUAL HELP NURSING HOME INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/16/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 519 E MADISON ST
-----------------------------------------------------
City | BROWNSVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78520-6082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-546-6745
-----------------------------------------------------
Fax | 956-546-0711
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 301 YUCCA ST
-----------------------------------------------------
City | SAN ANTONIO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78203-2351
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | MS. VERONICA CAHILL
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 210-533-5149
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 314000000X
-----------------------------------------------------
Taxonomy Name | Skilled Nursing Facility
-----------------------------------------------------
License Number | 45E502
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------