Provider Demographics
NPI:1124609789
Name:RJ MERIDIAN CARE OF EL CAMPO LLC
Entity type:Organization
Organization Name:RJ MERIDIAN CARE OF EL CAMPO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF FINANCES
Authorized Official - Prefix:
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:
Authorized Official - Last Name:FLORES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-827-5818
Mailing Address - Street 1:25009 OAKHURST DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-1975
Mailing Address - Country:US
Mailing Address - Phone:210-827-5818
Mailing Address - Fax:210-767-9560
Practice Address - Street 1:3515 WEST LOOP
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-8009
Practice Address - Country:US
Practice Address - Phone:979-541-5488
Practice Address - Fax:979-541-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030194OtherASSISTED LIVING FACILITY