MEDICARE: IHS ACQUISITION NO 132 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	112805	TX

General Provider Information

NPI Number	:	1932106051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IHS ACQUISITION NO 132 INC

Provider Business Mailing Address
First Line	:	2135 DENTON DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-3103
Country	:	US
Telephone Number	:	972-242-0667
Fax Number	:	972-242-8641

Provider Business Practice Location Address
First Line	:	2135 DENTON DR
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-3103
Country	:	US
Telephone Number	:	972-242-0667
Fax Number	:	972-242-8641

Authorized Official
Title or Position	:	CFO
Name	:	MR. TIM TRYBUS
Credential	:
Telephone Number	:	443-539-2354

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	11/13/2007

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