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Organization
HACKBERRY CREEK CARE CENTER, INC
Active
Organization
HACKBERRY CREEK CARE CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SEAB WASHINGTON (PRESIDENT, BOARD OF HACKBERRY CREEK)
(806) 347-2636
Entity
Organization
Contact information
Practice address
805 HARRISON AVE, MATADOR, TX 79244-2000
(806) 347-2942
(806) 347-2410
Mailing address
805 HARRISON AVE, P. O. BOX 651, MATADOR, TX 79244-2000
(806) 347-2942
(806) 347-2410
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
102868
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001014974
—
TX
01
—
102868
TEXAS FACILITY ID NUMBER
TX
Enumeration date
11/30/2006
Last updated
12/02/2008
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