| NPI | 1134205958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNY R. GIBBS Administrator 325-392-2671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 118031) |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2020-08-22 |