# GROVETON TEXAS HOSPITAL AUTHORITY

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

## Provider details

- **NPI number:** 1780710681
- **Authorized official:** JENNIFER LYNN CLEVELAND BOM (BUSINESS OFFICE MANAGER)
- **Authorized official phone:** (936) 642-1221

## Contact information

- **Practice address:** BOX 890 HWY 287 N, GROVETON, TX 75845-0890
- **Practice address phone:** (936) 642-1221
- **Practice address fax:** (936) 642-2727
- **Mailing address:** PO BOX 890, GROVETON, TX 75845-0890
- **Mailing address phone:** (936) 642-1221
- **Mailing address fax:** (936) 642-2727

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 117377 | TX | Yes |

## Other

- **Enumeration date:** 02/26/2007
- **Last updated:** 01/07/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004778 | FACILITY ID \# | TX |