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General NPI Number Information
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NPI Number | 1942209416
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Entity Type | Organization
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Legal Business Name | SENIOR HEALTH TULIA LLC
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Dates
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Enumeration Date | 07/18/2005
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 714 S AUSTIN
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City | TULIA
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State | TX
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Zip | 79088-0000
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Country | US
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Telephone | 806-995-4810
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Fax | 806-995-2263
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Provider Business Mailing Address
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Address Line | 714 S AUSTIN
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City | TULIA
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State | TX
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Zip | 79088-0000
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Country | US
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Telephone | 806-995-4810
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Fax | 806-995-2263
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Authorized Official
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Title or Position | REGIONAL CARE MANAGER
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Name | MR. LARRY LEE SNOW
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Credential | RN
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Telephone | 940-464-7016
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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 | 004559
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License Number State | TX
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