MYSTIC PARK NURSING & REHAB CENTER
NPI 1336537398
Skilled Nursing Facility in San Antonio, TX

Q: What is Mystic Park Scc LLC's NPI number?

The NPI number for Mystic Park Scc LLC is 1336537398. It was assigned to this organization in the NPPES registry on December 29, 2014. The provider is doing business as Mystic Park Nursing & Rehab Center.

Q: What is Mystic Park Scc LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Active since December 29, 2014CLIA 45D1020082 · Waiver

8503 MYSTIC PARK, SAN ANTONIO, TX 78254(210) 256-0906(210) 256-0925 Get Directions Write a Review

NPPES record last updated: March 3, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 3, 2020, Dec 6, 2018 (2 updates tracked since 2018).

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About Mystic Park Nursing & Rehab Center NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MYSTIC PARK NURSING & REHAB CENTER (NPI 1336537398) is a healthcare organization registered as a skilled nursing facility in San Antonio, Texas and active in the NPI registry since December 2014. The organization holds a CLIA Waiver certificate valid through December 9, 2027 and lists Michael Beal, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1336537398

Entity TypeOrganization

Primary Taxonomy314000000X

Legal Business NameMYSTIC PARK SCC LLC

Location Address8503 MYSTIC PARKSan Antonio, TX 78254-2544

Mailing Address600 N Pearl St Ste 1050Dallas, TX 75201-7495 · (214) 252-7600 · Fax (214) 252-7704

Phone(210) 256-0906

Fax(210) 256-0925

Organization SubpartNo

Authorized OfficialMichael BealChief Executive Officer · (214) 252-7600

Enumeration DateDecember 29, 2014

Last NPPES UpdateMarch 3, 20202 updates tracked since enumeration

NPPES CertifiedMarch 3, 2020

✔ NPI 1336537398 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities

Taxonomy Code314000000X

Definition

(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.

8503 MYSTIC PARK, San Antonio, TX 78254

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Other Names 1

Doing Business AsMystic Park Nursing & Rehab Center

Other Identifiers 2

Medicaid001026539TX

Other5447 101669TX · Vendorid/facility Id

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D1020082

Mystic Park Nursing & Rehabilitation Center · San Antonio, TX

Active · expires Dec 9, 2027

CLIA Number45D1020082

Laboratory TypeSkilled Nursing Facility/Nursing Facility

Certificate Effective DateDecember 10, 2025

Certificate Expiration DateDecember 9, 2027

Laboratory DirectorHope Brown

Laboratory Phone(210) 256-0906

Laboratory LocationMystic Park Nursing & Rehabilitation Center8503 Mystic Park, San Antonio, TX 78254

CLIA data matches this NPI record on: Address Phone

This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MANUEL HUERTA

Physical Therapist (Geriatrics)