Provider Demographics
NPI:1427162973
Name:TOWN HALL ESTATES-WHITNEY INC.
Entity type:Organization
Organization Name:TOWN HALL ESTATES-WHITNEY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:HAROLD
Authorized Official - Middle Name:D
Authorized Official - Last Name:WERNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-694-2233
Mailing Address - Street 1:PO BOX 1830
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-1830
Mailing Address - Country:US
Mailing Address - Phone:254-694-2233
Mailing Address - Fax:254-694-4457
Practice Address - Street 1:101 S SAN MARCOS ST
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2652
Practice Address - Country:US
Practice Address - Phone:254-694-2233
Practice Address - Fax:254-694-4457
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004809314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0004809Medicaid
TX676074Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER