MEDICARE: GOLDTHWAITE SENIOR HEALTH CENTER, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	4411	TX

General Provider Information

NPI Number	:	1083679666
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOLDTHWAITE SENIOR HEALTH CENTER, INC

Provider Business Mailing Address
First Line	:	1515 HERITAGE DR
Second Line	:	SUITE 212
City	:	MCKINNEY
State	:	TX
Zip	:	75069-3256
Country	:	US
Telephone Number	:	214-256-3787
Fax Number	:	214-256-3789

Provider Business Practice Location Address
First Line	:	1207 S REYNOLDS
Second Line	:	POB 607
City	:	GOLDTHWAITE
State	:	TX
Zip	:	76844
Country	:	US
Telephone Number	:	325-648-2258
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	HEIDI W BRASWELL
Credential	:
Telephone Number	:	214-256-3787

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	08/22/2020

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