Basic Information
| Provider Information | |||||||||
| NPI: | 1437221678 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | POST ACUTE MEDICAL AT VICTORIA, LLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | WARM SPRINGS SPECIALTY HOSPITAL OF VICTORIA | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4660 TRINDLE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | CAMP HILL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 170115610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7177308710 | ||||||||
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| Practice Location | |||||||||
| Address1: | 102 MEDICAL DR | ||||||||
| Address2: | |||||||||
| City: | VICTORIA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 779043101 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3615766200 | ||||||||
| FaxNumber: | 3615801213 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | MISITANO | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
| AuthorizedOfficialMiddleName: | F | ||||||||
| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 7177308710 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 284300000X | 000831 | TX | Y | Hospitals | Special Hospital |
No ID Information.