Organization
WIND CREST NURSING CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY M SCULLARK (MEDICARE COORDINATOR)
(863) 646-5951
Entity
Organization
Contact information
Practice address
607 W AVENUE B, COPPERAS COVE, TX 76522-1553
(254) 547-1033
(254) 542-3506
Mailing address
607 W AVENUE B, COPPERAS COVE, TX 76522-1553
(254) 547-1033
(254) 542-3506
Taxonomy
Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary
116809
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000515401
—
TX
05
—
021431401
—
TX
Enumeration date
07/04/2006
Last updated
06/21/2010
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