# CLEBURNE COUNTRY LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SUMMER PLACE NURSING & REHABILITATION
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174769483
- **Authorized official:** MR. JAMES W MOORE SR. (PRESIDENT)
- **Authorized official phone:** (409) 962-0910

## Contact information

- **Practice address:** 2485 S. MAJOR DRIVE, BEAUMONT, TX 77707-5019
- **Practice address phone:** (409) 861-4611
- **Mailing address:** 4500 MAIN AVE, GROVES, TX 77619-4712
- **Mailing address phone:** (409) 962-0910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | TX | Yes |

## Other

- **Enumeration date:** 12/17/2008
- **Last updated:** 02/03/2009