Provider Demographics
NPI:1275654030
Name:KCVT NURSING CENTERS,INC
Entity Type:Organization
Organization Name:KCVT NURSING CENTERS,INC
Other - Org Name:THE MOUNT VERNON HOUSE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMININSTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:S
Authorized Official - Last Name:ADAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-537-4857
Mailing Address - Street 1:PO BOX 777
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:75457-0777
Mailing Address - Country:US
Mailing Address - Phone:903-537-4857
Mailing Address - Fax:903-537-2833
Practice Address - Street 1:502 MEADOW PARK
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:TX
Practice Address - Zip Code:75457
Practice Address - Country:US
Practice Address - Phone:903-537-4857
Practice Address - Fax:903-537-2833
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119027310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility