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Organization

JACK COUNTY HOSPITAL DISTRICT

Active
Other names
FAITH COMMUNITY HOSPITAL RURAL HEALTH CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
KIM LEE (COO)
(940) 567-6633
Entity
Organization

Contact information

Practice address
215 CHISHOLM TRL, JACKSBORO, TX 76458-1403
(940) 567-6633
(940) 567-2895
Mailing address
215 CHISHOLM TRL, JACKSBORO, TX 76458-1403
(940) 567-6633
(940) 567-2895

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
000046
TX
261QR1300X
Rural Health Clinic/Center
Primary
100322
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
092126401
TX
05
092126402
TX
05
092126403
TX
Enumeration date
08/17/2005
Last updated
07/21/2022
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