Organization
MULBERRY MANOR LLC
Active
Other names
Mulberry Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA HUTCHESON (VICE PRESIDENT)
(254) 968-2158
Entity
Organization
Contact information
Practice address
1670 W LINGLEVILLE RD, STEPHENVILLE, TX 76401-1830
(254) 968-2158
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001014696
—
TX
Enumeration date
11/17/2006
Last updated
02/10/2009
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