Healthcare Provider Details

I. General information

NPI: 1003997941
Provider Name (Legal Business Name): CARE INN PROPERTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 W NOBLE ST
TROUP TX
75789-1502
US

IV. Provider business mailing address

1020 NE LOOP 410
SAN ANTONIO TX
78209-1204
US

V. Phone/Fax

Practice location:
  • Phone: 903-842-3118
  • Fax: 903-842-2645
Mailing address:
  • Phone: 210-828-5686
  • Fax: 210-824-4669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number117938
License Number StateTX

VIII. Authorized Official

Name: MR. CARL FELLBAUM
Title or Position: PRESIDENT
Credential:
Phone: 210-828-5686