# TOWN HALL ESTATES-KEENE INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104947811
- **Authorized official:** MR. WILLIAM JASON FAUTHEREE (ADMINISTRATOR)
- **Authorized official phone:** (817) 645-8888

## Contact information

- **Practice address:** 207 S OLD BETSY RD, KEENE, TX 76059-2426
- **Practice address phone:** (817) 645-8888
- **Practice address fax:** (817) 645-4984
- **Mailing address:** PO BOX 588, KEENE, TX 76059-0588
- **Mailing address phone:** (817) 645-8888
- **Mailing address fax:** (817) 645-4984

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 116903 | TX | — |
| 314000000X | Skilled Nursing Facility | 116903 | TX | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 04/06/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000440202 | — | TX |