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General NPI Number Information
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NPI Number | 1184665770
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Entity Type | Organization
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Legal Business Name | CUERO MANOR, INC.
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1010 MCARTHUR ST
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City | CUERO
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State | TX
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Zip | 77954-2317
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Country | US
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Telephone | 361-277-6133
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Fax | 361-275-6169
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Provider Business Mailing Address
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Address Line | 1010 MCARTHUR ST
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City | CUERO
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State | TX
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Zip | 77954-2317
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Country | US
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Telephone | 361-277-6133
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Fax | 361-275-6169
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Authorized Official
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Title or Position | CPA
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Name | MR. MICHAEL V. HULSEY
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Credential |
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Telephone | 405-948-1717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 313M00000X
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Taxonomy Name | Nursing Facility/Intermediate Care Facility
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License Number | 114758
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License Number State | TX
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