Provider Demographics
NPI:1073587275
Name:TEAGUE MANAGEMENT COMPANY
Entity Type:Organization
Organization Name:TEAGUE MANAGEMENT COMPANY
Other - Org Name:TEAGUE NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHELSIA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-562-3999
Mailing Address - Street 1:507 N SHERMAN ST
Mailing Address - Street 2:
Mailing Address - City:MEXIA
Mailing Address - State:TX
Mailing Address - Zip Code:76667-2343
Mailing Address - Country:US
Mailing Address - Phone:254-562-3999
Mailing Address - Fax:254-562-3099
Practice Address - Street 1:507 N SHERMAN ST
Practice Address - Street 2:
Practice Address - City:MEXIA
Practice Address - State:TX
Practice Address - Zip Code:76667-2343
Practice Address - Country:US
Practice Address - Phone:254-562-3999
Practice Address - Fax:254-562-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675884Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER