Healthcare Provider Details

I. General information

NPI: 1992199756
Provider Name (Legal Business Name): WHITESBORO HEALTH CARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2015
Last Update Date: 03/19/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 SHERMAN DR
WHITESBORO TX
76273-9564
US

IV. Provider business mailing address

211 N BROADWAY STE 2035
SAINT LOUIS MO
63102-2727
US

V. Phone/Fax

Practice location:
  • Phone: 903-564-7900
  • Fax:
Mailing address:
  • Phone: 314-588-7518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MOSHE ORLINSKY
Title or Position: MANAGER
Credential:
Phone: 314-588-7518