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Organization
COUNTRY CLUB NURSING AND REHABILITATION LP
Active
Organization
COUNTRY CLUB NURSING AND REHABILITATION LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN D. FLAGG (CEO)
(940) 387-4388
Entity
Organization
Contact information
Practice address
9 MEDICAL DR, AMARILLO, TX 79106-4137
(806) 352-2731
(806) 353-9507
Mailing address
419 S ELM ST, DENTON, TX 76201-6085
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004469
—
TX
01
—
094528901
TMHP CROSS OVER
TX
Enumeration date
09/30/2005
Last updated
01/30/2019
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