1962710079 NPI number — SWEET NECHES PROPERTIES, LTD.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962710079 NPI number — SWEET NECHES PROPERTIES, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SWEET NECHES PROPERTIES, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
RAYBURN HEALTH CARE & REHABILITATION
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962710079
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 E ASH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75949-8648
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
936-876-2273
Provider Business Mailing Address Fax Number:
936-876-2286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 BULLDOG AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JASPER
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75951-4949
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
936-212-2621
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2010

Additional Information

Authorized Official

Authorized Official Last Name:
DAVIS
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
MANAGER OF GENERAL PARTNER
Authorized Official Telephone Number:
936-212-2621

Provider Taxonomy Codes

  • Taxonomy code: 314000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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