# COUNTY OF KENT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kent County Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477507374
- **Authorized official:** JORDAN MOELLER (ADMINISTRATOR)
- **Authorized official phone:** (806) 237-3036

## Contact information

- **Practice address:** 1443 NORTH MAIN STREET, JAYTON, TX 79528-0086
- **Practice address phone:** (806) 237-3036
- **Practice address fax:** (806) 237-2090
- **Mailing address:** 1443 NORTH MAIN STREET, P.O. BOX 86, JAYTON, TX 79528-0086
- **Mailing address phone:** (806) 237-3036
- **Mailing address fax:** (806) 237-2090

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 111179 | TX | — |
| 314000000X | Skilled Nursing Facility | — | — | Yes |

## Other

- **Enumeration date:** 05/22/2006
- **Last updated:** 12/14/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000420206 | — | TX |