Organization
NOCONA-HENRIETTA HEALTH PROPERTIES INC
Active
Other names
Henrietta Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JAKE HALLSTED (MANAGER)
(832) 448-3700
Entity
Organization
Contact information
Practice address
807 W BOIS D ARC ST, HENRIETTA, TX 76365-3232
(940) 538-4303
(940) 538-5576
Mailing address
807 W BOIS D ARC ST, HENRIETTA, TX 76365-3232
(940) 538-4303
(940) 538-5576
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116479
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000438404
—
TX
01
—
021591501
MEDICAID TPI
TX
Enumeration date
06/21/2006
Last updated
06/04/2013
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