Healthcare Provider Details

I. General information

NPI: 1427086024
Provider Name (Legal Business Name): NEWBURN HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

421 S BONNER ST
JACKSONVILLE TX
75766-2330
US

IV. Provider business mailing address

421 S. BONNER ST.
JACKSONVILLE TX
75766-2330
US

V. Phone/Fax

Practice location:
  • Phone: 903-586-9871
  • Fax: 903-586-5866
Mailing address:
  • Phone: 903-586-9871
  • Fax: 903-586-5866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number116336
License Number StateTX

VIII. Authorized Official

Name: MS. JAN L BRAZIER
Title or Position: ADMINISTRATOR
Credential: ADM.
Phone: 903-586-9871