| NPI | 1063445203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDITH SOHRT MOLBERG Administrator 979-648-2628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 109078) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |