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General NPI Number Information
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NPI Number | 1265407407
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Entity Type | Organization
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Legal Business Name | GRAPELAND NURSING CENTER, LTD
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1108 EAST LOOP 304
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City | CROCKETT
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State | TX
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Zip | 75835-0997
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Country | US
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Telephone | 936-544-0150
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 997
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City | CROCKETT
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State | TX
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Zip | 75835-0997
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Country | US
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Telephone | 936-544-0150
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Fax | 936-544-2929
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT WINFIELD
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Credential |
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Telephone | 936-544-2192
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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 | 116525
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License Number State | TX
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