Healthcare Provider Details
I. General information
NPI: 1649082587
Provider Name (Legal Business Name): GHC HAMLIN OPERATIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2025
Last Update Date: 02/09/2025
Certification Date: 02/09/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
425 SW AVENUE F
HAMLIN TX
79520-4615
US
IV. Provider business mailing address
4150 INTERNATIONAL PLZ STE 102
FORT WORTH TX
76109-4846
US
V. Phone/Fax
- Phone: 325-576-3643
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
LEON
EVANS
Title or Position: MANAGER
Credential:
Phone: 682-305-7150