Healthcare Provider Details

I. General information

NPI: 1609945708
Provider Name (Legal Business Name): BRONTE HEALTH AND REHAB CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 06/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 S. STATE ST
BRONTE TX
76933-0407
US

IV. Provider business mailing address

PO BOX M
BRONTE TX
76933-0407
US

V. Phone/Fax

Practice location:
  • Phone: 325-473-3621
  • Fax: 325-473-3472
Mailing address:
  • Phone: 325-473-3621
  • Fax: 325-473-3472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number111713
License Number StateTX

VIII. Authorized Official

Name: MR. PATRICK YOUNG
Title or Position: ADMINISTRATOR
Credential:
Phone: 325-473-3621