Healthcare Provider Details

I. General information

NPI: 1760851323
Provider Name (Legal Business Name): WINTERS HC OPERATOR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2015
Last Update Date: 06/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

506 VAN NESS ST
WINTERS TX
79567-4724
US

IV. Provider business mailing address

111 CLIFTON AVE
LAKEWOOD NJ
08701-3342
US

V. Phone/Fax

Practice location:
  • Phone: 325-754-4566
  • Fax: 325-754-4634
Mailing address:
  • Phone: 214-396-3462
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KARIN FALKINBURG
Title or Position: EXECUTIVE ASSISTANT
Credential:
Phone: 214-396-3462