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General NPI Number Information
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NPI Number | 1548653082
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Entity Type | Organization
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Legal Business Name | CHILDRESS COUNTY HOSPITAL DISTRICT
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 04/30/2018
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Provider Practice Location Address
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Address Line | 805 HARRISON AVE
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City | MATADOR
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State | TX
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Zip | 79244-2000
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Country | US
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Telephone | 832-467-6000
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Fax |
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Provider Business Mailing Address
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Address Line | 805 HARRISON AVE
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City | MATADOR
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State | TX
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Zip | 79244-2000
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SENIOR DIRECTOR A/R
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Name | KELLE C SANTORO
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Credential |
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Telephone | 832-467-5728
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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 | 142933
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License Number State | TX
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