Organization
PRAIRIE ACRES
Active
Other names
Friona Heritage Estates
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLE M. BRISTER LNFA (ADMINISTRATOR)
(806) 250-3922
Entity
Organization
Contact information
Practice address
201 E. 15TH STREET, FRIONA, TX 79035
(806) 250-3922
(806) 250-2132
Mailing address
201 E. 15TH STREET, FRIONA, TX 79035
(806) 250-3922
(806) 250-2132
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
107250
TX
310400000X
Assisted Living Facility
126276
TX
313M00000X
Nursing Facility/Intermediate Care Facility
111644
TX
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
125044
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000509501
—
TX
05
—
001001908
—
TX
05
—
021936201
—
TX
01
—
1280270001
MEDICARE DMERC
—
Enumeration date
12/13/2005
Last updated
04/09/2009
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