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General NPI Number Information
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NPI Number | 1891783429
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Entity Type | Organization
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Legal Business Name | ELECTRA HEALTH CARE CENTER
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Dates
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Enumeration Date | 10/07/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 511 S BAILEY ST
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City | ELECTRA
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State | TX
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Zip | 76360-2828
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Country | US
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Telephone | 940-495-2184
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Fax | 940-495-3171
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Provider Business Mailing Address
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Address Line | 511 S BAILEY ST P.O. BOX 1226
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City | ELECTRA
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State | TX
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Zip | 76360-2828
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Country | US
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Telephone | 940-495-2184
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Fax | 940-495-3171
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. SANDRA J GIVENS
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Credential |
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Telephone | 940-495-2184
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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 | 110882
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License Number State | TX
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