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NPI Code Detail

MEDICARE: MAHARLIKA RESOURCES, INC.

MEDICARE: MAHARLIKA RESOURCES, 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
1310400000XAssisted Living Facility102640TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1102640OTHERTXASSISTED LIVING FACILITY

General Provider Information

NPI Number : 1457551749
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAHARLIKA RESOURCES, INC.
Provider Business Mailing Address
First Line : 11913 PASEO DORADO CIR
Second Line :
City : EL PASO
State : TX
Zip : 79936-3785
Country : US
Telephone Number : 915-329-1039
Fax Number : 866-838-4666
Provider Business Practice Location Address
First Line : 2201 JUNCTION HWY
Second Line :
City : KERRVILLE
State : TX
Zip : 78028-9392
Country : US
Telephone Number : 830-792-4001
Fax Number : 866-838-4666
Authorized Official
Title or Position : CEO
Name : DIONICIO R RIVERA
Credential :
Telephone Number : 915-329-1039
Provider Enumeration Date : 07/24/2007
Last Update Date : 11/27/2007

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Directions to “MAHARLIKA RESOURCES, INC. ” Practice Location

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