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Organization
GOODALL-WITCHER HOSPITAL AUTHORITY
Active
Organization
GOODALL-WITCHER HOSPITAL AUTHORITY
Active
Other names
Sunset Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADAM B WILLMANN (PRESIDENT/CEO)
(254) 675-7995
Entity
Organization
Contact information
Practice address
1800 W 9TH ST, CLIFTON, TX 76634-1880
(254) 675-8637
(254) 675-3248
Mailing address
1800 W 9TH ST, CLIFTON, TX 76634-1880
(254) 675-8637
(254) 675-3248
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025615
—
TX
01
—
004059
MEDICAID VENDOR ID
TX
Enumeration date
11/27/2013
Last updated
02/18/2014
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