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General NPI Number Information
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NPI Number | 1033169636
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Entity Type | Organization
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Legal Business Name | TRINITY MISSION OF GRANBURY, LLC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 04/12/2012
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Provider Practice Location Address
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Address Line | 600 REUNION CT
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City | GRANBURY
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State | TX
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Zip | 76048-1610
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Country | US
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Telephone | 817-573-3773
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Fax | 817-573-0103
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Provider Business Mailing Address
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Address Line | 600 REUNION CT
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City | GRANBURY
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State | TX
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Zip | 76048-1610
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Country | US
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Telephone | 817-573-3773
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Fax | 817-573-0103
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | CHRISTOPHER J MURPHY
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Credential |
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Telephone | 901-937-7994
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 116586
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License Number State | TX
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