Diversicare Leasing Corp.

NPI #1376531343 in Lockhart, Texas

Provider Information

NPI Number
1376531343
Entity Type
Organization
Organization Name
Diversicare Leasing Corp.
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 12, 2005
Last Updated
Aug 22, 2020

Practice Location

Address
107 N MEDINA ST
State
Texas
ZIP Code
78644-1919
Phone
(512) 398-5213

Authorized Official

Name
RAYMOND L. TYLER JR.
Title
EXECUTIVE VICE PRESIDENT AND COO
Phone
(615) 771-7575

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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