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Contact Information

CLYDE NURSING CENTER, L.P
806 STEPHENS ST
CLYDE, TX79510-4554
 Phone: 325-893-4288
 Fax: 325-893-2568
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Skilled Nursing Facility

314000000X A1[8] Skilled Nursing Facility
 

Nursing Facility Supplies

332BN1400X 87 All Other Suppliers
 

Parenteral & Enteral Nutrition

332BP3500X 87 All Other Suppliers
Indicates primary specialty

NPI Profile & details for CLYDE NURSING CENTER, L.P

NPI # 1730177718
LBN Legal business name CLYDE NURSING CENTER, L.P
Authorized official PETER LICARI - (PRESIDENT OF GENERAL PARTNER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/12/2005
Last updated 10/26/2007 - About 19 years ago
Identifiers
TX License # 108904
TX License # 114462
TX Medicaid 004395
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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