Provider Demographics
NPI:1396813028
Name:LUTHERAN SUNSET MINISTRIES
Entity type:Organization
Organization Name:LUTHERAN SUNSET MINISTRIES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MARSHA
Authorized Official - Middle Name:BOSWELL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-675-8637
Mailing Address - Street 1:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:CLIFTON
Mailing Address - State:TX
Mailing Address - Zip Code:76634-0071
Mailing Address - Country:US
Mailing Address - Phone:254-675-8637
Mailing Address - Fax:254-675-2245
Practice Address - Street 1:1800 WEST 9TH
Practice Address - Street 2:
Practice Address - City:CLIFTON
Practice Address - State:TX
Practice Address - Zip Code:76634
Practice Address - Country:US
Practice Address - Phone:254-675-8637
Practice Address - Fax:254-675-2245
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LUTHERAN SUNSET MINISTRIES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-01
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004059314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004059Medicaid
TX675826Medicare Oscar/Certification