Basic Information
| Provider Information | |||||||||
| NPI: | 1700541380 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SIMPATICO EAST OPERATIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8933 ANKERSON ST | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799041320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9154743537 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1991 SAUL KLEINFELD DR | ||||||||
| Address2: | |||||||||
| City: | EL PASO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 799363757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9158575487 | ||||||||
| FaxNumber: | 9158570807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2021 | ||||||||
| LastUpdateDate: | 11/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | BITTNER | ||||||||
| AuthorizedOfficialFirstName: | BARBARA | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 9203781913 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | N/A | ||||||||
| NPICertificationDate: | 10/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 311500000X | N | Nursing & Custodial Care Facilities | Alzheimer Center (Dementia Center) | 310400000X | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.