Healthcare Provider Details

I. General information

NPI: 1508955386
Provider Name (Legal Business Name): RUNNELS COUNTY REHABILITIATION & NURSING CENTER 1 LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 N BROADWAY ST
BALLINGER TX
76821-2418
US

IV. Provider business mailing address

1800 N BROADWAY ST
BALLINGER TX
76821-2418
US

V. Phone/Fax

Practice location:
  • Phone: 325-365-2538
  • Fax: 325-365-2530
Mailing address:
  • Phone: 325-365-2538
  • Fax: 325-365-2530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number117630
License Number StateTX

VIII. Authorized Official

Name: JOHN B DIFRANCESCO JR.
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 325-365-2538