Organization
INDEPENDENT ORDER OF ODD FELLOWS GRAND LODGE 100F OF TEXAS
Active
Other names
Odd Fellow and Rebekah Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES M CURTIS (GRAND SECRETARY)
(903) 872-7438
Entity
Organization
Contact information
Practice address
2300 S OAK GROVE RD, ENNIS, TX 75119-6841
(972) 875-8643
(972) 875-1179
Mailing address
2300 S OAK GROVE RD, ENNIS, TX 75119-6841
(972) 875-8643
(972) 875-1179
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
114389
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000456001
—
TX
05
—
190096101
—
TX
Enumeration date
09/20/2005
Last updated
02/13/2019
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