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Contact Information

BURLESON ST. JOSEPH MANOR
1022 PRESIDENTIAL CORRIDOR EAST
CALDWELL, TX77836-4611
 Phone: 979-567-0920
 Fax: 979-567-4811
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nursing Facility/Intermediate Care Facility

313M00000X A3[10] Other Nursing Facility
Indicates primary specialty

NPI Profile & details for BURLESON ST. JOSEPH MANOR

NPI # 1184627093
LBN Legal business name BURLESON ST. JOSEPH MANOR
Authorized official HAROLD COTTRELL - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/24/2005
Last updated 01/25/2010 - About 16 years ago
Identifiers
TX License # 107880
TX Medicaid 001000513
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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