MEDICARE: THE ARBORETUM NURSING AND REHABILITATION CENTER OF WINNIE, 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	108035	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508863515
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ARBORETUM NURSING AND REHABILITATION CENTER OF WINNIE, INC.

Provider Business Mailing Address
First Line	:	PO BOX 7230
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77903-7230
Country	:	US
Telephone Number	:	361-576-9454
Fax Number	:	361-576-2994

Provider Business Practice Location Address
First Line	:	1215 HIGHWAY 124
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-9005
Country	:	US
Telephone Number	:	409-296-8200
Fax Number	:	409-296-8212

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. BYRON BURRIS II
Credential	:
Telephone Number	:	361-576-9454

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	09/18/2009

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