Healthcare Provider Details

I. General information

NPI: 1881680106
Provider Name (Legal Business Name): GAINESVILLE HEALTH CARE CENTER LTD. CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2005
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 BLACK HILL DR
GAINESVILLE TX
76240-4625
US

IV. Provider business mailing address

2537 GOLDEN BEAR DR
CARROLLTON TX
75006-2377
US

V. Phone/Fax

Practice location:
  • Phone: 940-665-5221
  • Fax: 940-665-0306
Mailing address:
  • Phone: 214-954-4114
  • Fax: 214-871-3057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number110722
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROBIN UNDERHILL
Title or Position: CHIEF EXECUTIVE
Credential:
Phone: 214-954-4114