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General NPI Number Information
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NPI Number | 1548381437
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN MANOR, INC.
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4600 TAFT BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-4935
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Country | US
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Telephone | 940-691-1710
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Fax | 940-691-3742
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Provider Business Mailing Address
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Address Line | 4600 TAFT BLVD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-4935
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Country | US
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Telephone | 940-691-1710
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Fax | 940-691-3742
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. WILLIAM JAMES OAKLEY
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Credential |
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Telephone | 940-691-1710
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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 | 000143
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License Number State | TX
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