Healthcare Provider Details

I. General information

NPI: 1851578892
Provider Name (Legal Business Name): SEARS CAPROCK RETIREMENT CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/22/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7171 BUFFALO GAP
ABILENE TX
79606-5450
US

IV. Provider business mailing address

1 VILLAGE DR SUITE 400
ABILENE TX
79606-8231
US

V. Phone/Fax

Practice location:
  • Phone: 325-691-5519
  • Fax: 325-698-4582
Mailing address:
  • Phone: 325-691-5519
  • Fax: 325-698-4582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: NANCY S. JOHNSON
Title or Position: SENIOR VICE PRESIDENT/CFO
Credential: CPA
Phone: 325-691-5519