Provider Demographics
NPI:1275524407
Name:CHRISTIAN CARE CENTERS, INC
Entity Type:Organization
Organization Name:CHRISTIAN CARE CENTERS, INC
Other - Org Name:HILLTOP HAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BOGGS
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:817-430-0162
Mailing Address - Street 1:PO BOX 39
Mailing Address - Street 2:
Mailing Address - City:GUNTER
Mailing Address - State:TX
Mailing Address - Zip Code:75058-0039
Mailing Address - Country:US
Mailing Address - Phone:817-430-0162
Mailing Address - Fax:866-529-7016
Practice Address - Street 1:308 E COLLEGE ST
Practice Address - Street 2:
Practice Address - City:GUNTER
Practice Address - State:TX
Practice Address - Zip Code:75058-9731
Practice Address - Country:US
Practice Address - Phone:817-430-0162
Practice Address - Fax:866-529-7016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111777314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX67-5576Medicare ID - Type Unspecified