Provider Demographics
NPI:1164856803
Name:CHILDRESS COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:CHILDRESS COUNTY HOSPITAL DISTRICT
Other - Org Name:TULIA HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLCOMB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-937-9178
Mailing Address - Street 1:714 S AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:TULIA
Mailing Address - State:TX
Mailing Address - Zip Code:79088-3025
Mailing Address - Country:US
Mailing Address - Phone:806-995-4810
Mailing Address - Fax:806-995-2263
Practice Address - Street 1:714 S AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:TULIA
Practice Address - State:TX
Practice Address - Zip Code:79088-3025
Practice Address - Country:US
Practice Address - Phone:806-995-4810
Practice Address - Fax:806-995-2263
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-29
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004559OtherMEDICAID VENDOR ID
TX001025489Medicaid
TX004559OtherMEDICAID VENDOR ID