Organization
COUNTY OF KENT
Active
Other names
Kent County Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
JORDAN MOELLER (ADMINISTRATOR)
(806) 237-3036
Entity
Organization
Contact information
Practice address
1443 NORTH MAIN STREET, JAYTON, TX 79528-0086
(806) 237-3036
(806) 237-2090
Mailing address
1443 NORTH MAIN STREET, P.O. BOX 86, JAYTON, TX 79528-0086
(806) 237-3036
(806) 237-2090
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
111179
TX
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000420206
—
TX
Enumeration date
05/22/2006
Last updated
12/14/2021
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