Organization
BURLESON ST. JOSEPH MANOR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD COTTRELL LNFA (EXECUTIVE DIRECTOR)
(979) 567-0920
Entity
Organization
Contact information
Practice address
1022 PRESIDENTIAL CORRIDOR EAST, CALDWELL, TX 77836-4611
(979) 567-0920
(979) 567-4811
Mailing address
1022 PRESIDENTIAL CORRIDOR EAST, CALDWELL, TX 77836-4611
(979) 567-0920
(979) 567-4811
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
107880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001000513
—
TX
Enumeration date
05/24/2005
Last updated
01/25/2010
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