Healthcare Provider Details

I. General information

NPI: 1407832223
Provider Name (Legal Business Name): WELLINGTON CARE CENTER INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2005
Last Update Date: 12/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1506 CHILDRESS ST
WELLINGTON TX
79095-4108
US

IV. Provider business mailing address

1506 CHILDRESS ST
WELLINGTON TX
79095-4108
US

V. Phone/Fax

Practice location:
  • Phone: 806-447-2777
  • Fax: 806-259-5098
Mailing address:
  • Phone: 806-447-2777
  • Fax: 806-259-5098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number110939
License Number StateTX

VIII. Authorized Official

Name: MS. ANGELIN DICKSON
Title or Position: REGIONAL ADMINISTRATOR
Credential: LNFA
Phone: 806-259-3566