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PARK PLACE TYLER HC LLC NPI 1184954828


NPI Information

NPI: 1184954828
Provider Name: PARK PLACE TYLER HC, LLC

Doing Business As: PARK PLACE NURSING & REHAB

Classification: Nursing Facility/Intermediate Care Facility - 313M00000X
Entity Type: Organization
Address:
2450 E 5TH ST
TYLER, TX
ZIP 75701
Phone: (903) 592-6745
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PARK PLACE TYLER HC, LLC is a nursing facility intermediate care facility in Tyler, TX. The provider is an institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals. PARK PLACE TYLER HC, LLC NPI is 1184954828. The provider is registered as an organization entity type.
The provider Is Doing Business As Park Place Nursing & Rehab.

The provider's business location address is:

2450 E 5TH ST
TYLER, TX
ZIP 75701-525
Phone: (903) 592-6745
Fax: (903) 592-1088

The provider's authorized official is Sharon Kay Redd .
The authorized official title is Reimbursement Specialists and has the following contact phone number (903) 881-9432.

The enumeration date for this NPI number is 12/31/2009 and was last updated on 12/31/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1313M00000XNursing Facility/Intermediate Care FacilityTEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1676005MEDICARE UPINTEXAS
2001012142MEDICAIDTEXAS
35390MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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