Healthcare Provider Details

I. General information

NPI: 1700439692
Provider Name (Legal Business Name): WESTERN HILLS HH OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2019
Last Update Date: 07/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLD SIDNEY RD
COMANCHE TX
76442-2137
US

IV. Provider business mailing address

400 OLD SIDNEY RD
COMANCHE TX
76442-2137
US

V. Phone/Fax

Practice location:
  • Phone: 325-356-2571
  • Fax:
Mailing address:
  • Phone: 325-356-2571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL LITTLE
Title or Position: MANAGER
Credential:
Phone: 512-520-7320