Basic Information
| Provider Information | |||||||||
| NPI: | 1457340168 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SENIOR MANAGEMENT SERVICES OF EL PASO CORONADO INC | ||||||||
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| OtherOrganizationName: | CORONADO NURSING CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 W ARBROOK BLVD | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760154327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8174681991 | ||||||||
| FaxNumber: | 8174683133 | ||||||||
| Practice Location | |||||||||
| Address1: | 223 S RESLER DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799124303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9155849417 | ||||||||
| FaxNumber: | 9158336596 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/14/2005 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | CLANTON | ||||||||
| AuthorizedOfficialFirstName: | TROY | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8174681991 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 114840 | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.