Healthcare Provider Details

I. General information

NPI: 1710977707
Provider Name (Legal Business Name): HEALTH SELECT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 04/16/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 S MEMORIAL DR
PECOS TX
79772-7036
US

IV. Provider business mailing address

1819 S MEMORIAL DR P.O. BOX 1461
PECOS TX
79772-7036
US

V. Phone/Fax

Practice location:
  • Phone: 432-447-2183
  • Fax: 432-447-6053
Mailing address:
  • Phone: 432-447-2183
  • Fax: 432-447-6053

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number114047
License Number StateTX

VIII. Authorized Official

Name: MS. MARANNA J DEATON
Title or Position: ADMINISTRATOR
Credential: LNFA, LBSW
Phone: 432-447-2183