MEDICARE: CARING PALMS HEALTH CARE CENTER, 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	315P00000X	Intellectual Disabilities Intermediate Care Facility		TX

General Provider Information

NPI Number	:	1578734224
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARING PALMS HEALTH CARE CENTER, INC

Provider Business Mailing Address
First Line	:	401 N CARROLL AVE # 157
Second Line	:
City	:	SOUTHLAKE
State	:	TX
Zip	:	76092-6407
Country	:	US
Telephone Number	:	817-992-2028
Fax Number	:	817-595-1950

Provider Business Practice Location Address
First Line	:	1415 W WASHINGTON ST
Second Line	:
City	:	BROWNSVILLE
State	:	TX
Zip	:	78520-6549
Country	:	US
Telephone Number	:	956-546-3714
Fax Number	:	956-546-3799

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JEFFREY A HEAD
Credential	:
Telephone Number	:	817-992-2028

Provider Enumeration Date	:	03/20/2008
Last Update Date	:	03/20/2008

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