Provider Demographics
NPI:1003956020
Name:MARJORIE S. HUDSON HOUSE
Entity Type:Organization
Organization Name:MARJORIE S. HUDSON HOUSE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JILL
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:BENSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-226-4011
Mailing Address - Street 1:PO BOX 190
Mailing Address - Street 2:
Mailing Address - City:CLAUDE
Mailing Address - State:TX
Mailing Address - Zip Code:79019-0190
Mailing Address - Country:US
Mailing Address - Phone:806-226-4011
Mailing Address - Fax:806-226-7037
Practice Address - Street 1:301 TRICE STREET
Practice Address - Street 2:
Practice Address - City:CLAUDE
Practice Address - State:TX
Practice Address - Zip Code:79019-0190
Practice Address - Country:US
Practice Address - Phone:806-226-4011
Practice Address - Fax:806-226-7037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-07
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility