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General NPI Number Information
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NPI Number | 1447232368
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Entity Type | Organization
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Legal Business Name | PHPM MISSION CARE CENTERS - NEW COVENANT
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Dates
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Enumeration Date | 11/16/2005
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Last Update Date | 04/06/2016
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Provider Practice Location Address
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Address Line | 3727 W RANCH ROAD 1431
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City | KINGSLAND
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State | TX
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Zip | 78639-3244
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Country | US
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Telephone | 325-388-4538
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Fax | 325-388-6894
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Provider Business Mailing Address
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Address Line | 5420 W PLANO PKWY
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City | PLANO
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State | TX
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Zip | 75093-4823
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Country | US
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Telephone | 972-931-3800
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Fax | 972-767-6222
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Authorized Official
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Title or Position | DIRECTOR OF REIMBURSEMENT
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Name | MRS. JAMIE LATTURE COLLIER
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Credential |
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Telephone | 972-931-3800
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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 | 113258
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License Number State | TX
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