Healthcare Provider Details

I. General information

NPI: 1740307420
Provider Name (Legal Business Name): BAPTIST COMMUNITY AFFORDABLE HOUSING FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 MEDI PARK DR
AMARILLO TX
79106-2104
US

IV. Provider business mailing address

1910 MEDI PARK DR
AMARILLO TX
79106-2104
US

V. Phone/Fax

Practice location:
  • Phone: 806-457-4700
  • Fax: 806-457-4608
Mailing address:
  • Phone: 806-457-4700
  • Fax: 806-457-4608

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number119655
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number119655
License Number StateTX

VIII. Authorized Official

Name: MR. ROBERT SMITH
Title or Position: ADMINISTRATOR
Credential:
Phone: 806-457-4600