| NPI | 1508973280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN D FELLS Administrator 409-963-1266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 509601) |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: TX 5906) |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2008-08-12 |