MEDICARE: RGV ELDER HEALTH SYSTEMS, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility	131994	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1548477748	OTHER	TX	NPI NUMBER FOR ANOTHER D/B/A BEST HEALTH SERVICES
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245508407
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RGV ELDER HEALTH SYSTEMS, INC

Provider Business Mailing Address
First Line	:	PO BOX 1893
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78573-0031
Country	:	US
Telephone Number	:	956-583-8013
Fax Number	:	956-583-5120

Provider Business Practice Location Address
First Line	:	9500 HWY 107
Second Line	:
City	:	MISSION
State	:	TX
Zip	:	78573-8247
Country	:	US
Telephone Number	:	956-583-8013
Fax Number	:	956-583-5120

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BENJAMIN MADRIGALES
Credential	:	LVN
Telephone Number	:	956-533-6825

Provider Enumeration Date	:	12/02/2011
Last Update Date	:	12/02/2011

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