Provider Demographics
NPI:1164138236
Name:PRIVATE HEALTHCARE FACILITIES
Entity Type:Organization
Organization Name:PRIVATE HEALTHCARE FACILITIES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMIN
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-341-8598
Mailing Address - Street 1:902 KITTY HAWK RD # 170487
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-3825
Mailing Address - Country:US
Mailing Address - Phone:866-996-2340
Mailing Address - Fax:888-329-2091
Practice Address - Street 1:613 KINGWOOD ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-3405
Practice Address - Country:US
Practice Address - Phone:866-996-2340
Practice Address - Fax:888-329-2091
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NW0100XHospitalsGeneral Acute Care HospitalWomen