Provider Demographics
NPI:1134328396
Name:HAMILTON RIDGE OPERATIONS, LLC
Entity Type:Organization
Organization Name:HAMILTON RIDGE OPERATIONS, LLC
Other - Org Name:DOVE HILL CARE CENTER & VILLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:HARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-335-4111
Mailing Address - Street 1:306 W 7TH STREET, SUITE 415
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76102
Mailing Address - Country:US
Mailing Address - Phone:817-335-4111
Mailing Address - Fax:817-335-0800
Practice Address - Street 1:1315 E. STATE HIGHWAY 22
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:TX
Practice Address - Zip Code:76531
Practice Address - Country:US
Practice Address - Phone:254-386-3171
Practice Address - Fax:254-386-8261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
314000000X
TX1015270314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001015270Medicaid
TX675140Medicare Oscar/Certification