Healthcare Provider Details

I. General information

NPI: 1801803267
Provider Name (Legal Business Name): COUNTY OF CLAY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 08/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S ARCHER ST
HENRIETTA TX
76365-3301
US

IV. Provider business mailing address

310 W SOUTH ST
HENRIETTA TX
76365-3346
US

V. Phone/Fax

Practice location:
  • Phone: 940-235-1274
  • Fax: 940-235-1280
Mailing address:
  • Phone: 940-538-5621
  • Fax: 940-235-1215

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number002151
License Number StateTX

VIII. Authorized Official

Name: MRS. FRAN GRUNDY
Title or Position: DIRECTOR
Credential: LVN
Phone: 940-538-5621