Provider Demographics
NPI:1265867709
Name:MITCHELL COUNTY HOSPITAL DISTICT
Entity Type:Organization
Organization Name:MITCHELL COUNTY HOSPITAL DISTICT
Other - Org Name:ARBOR TERRACE HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBBIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWBERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-728-3431
Mailing Address - Street 1:609 RIO CONCHO DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76903-6029
Mailing Address - Country:US
Mailing Address - Phone:325-653-1266
Mailing Address - Fax:325-655-6938
Practice Address - Street 1:609 RIO CONCHO DR
Practice Address - Street 2:
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76903-6029
Practice Address - Country:US
Practice Address - Phone:325-653-1266
Practice Address - Fax:325-655-6938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004815Medicaid