MEDICARE: SILVER PINES NURSING AND REHABILITATION LP

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	314000000X	Skilled Nursing Facility	111209	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	021934702	OTHER	TX	TMHP CROSSOVER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932195708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SILVER PINES NURSING AND REHABILITATION LP

Provider Business Mailing Address
First Line	:	401 N ELM ST
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-4137
Country	:	US
Telephone Number	:	940-387-4388
Fax Number	:	940-380-2410

Provider Business Practice Location Address
First Line	:	503 OLD AUSTIN HWY
Second Line	:
City	:	BASTROP
State	:	TX
Zip	:	78602-5016
Country	:	US
Telephone Number	:	512-321-6220
Fax Number	:	512-321-6616

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MICHAEL A RICH
Credential	:
Telephone Number	:	940-387-4388

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	04/02/2012

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