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General NPI Number Information
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NPI Number | 1851394605
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Entity Type | Organization
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Legal Business Name | BRUNETT HEALTHCARE,INC
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Dates
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Enumeration Date | 05/24/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1908 6TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-2124
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Country | US
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Telephone | 940-322-2193
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Fax |
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Provider Business Mailing Address
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Address Line | 1908 6TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-2124
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Country | US
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Telephone | 940-322-2193
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CHRISTINA L BURNETT
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Credential |
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Telephone | 903-948-6841
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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 | 112724
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License Number State | TX
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