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General NPI Number Information
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NPI Number | 1649504036
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Entity Type | Organization
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Legal Business Name | AMERISA, INC.
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Dates
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Enumeration Date | 10/01/2009
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Last Update Date | 11/02/2009
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Provider Practice Location Address
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Address Line | 313 N. LEE SUTIE B
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City | HEREFORD
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State | TX
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Zip | 79045-7904
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Country | US
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Telephone | 806-591-0016
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Fax |
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Provider Business Mailing Address
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Address Line | 313 N. LEE SUITE B
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City | HEREFORD
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State | TX
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Zip | 79045-7904
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Country | US
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Telephone | 806-336-6554
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Fax |
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Authorized Official
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Title or Position | CEO/PRESIDENT
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Name | ROY PUENTE
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Credential |
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Telephone | 806-591-0016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 67-2080
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License Number State | TX
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