Provider Demographics
NPI:1407190903
Name:SOMERVELL COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:SOMERVELL COUNTY HOSPITAL DISTRICT
Other - Org Name:GLEN ROSE NURSING AND REHAB CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:HONEA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-897-1422
Mailing Address - Street 1:PO BOX 7300
Mailing Address - Street 2:
Mailing Address - City:GLEN ROSE
Mailing Address - State:TX
Mailing Address - Zip Code:76043-7300
Mailing Address - Country:US
Mailing Address - Phone:817-578-7344
Mailing Address - Fax:
Practice Address - Street 1:1019 HOLDEN ST
Practice Address - Street 2:
Practice Address - City:GLEN ROSE
Practice Address - State:TX
Practice Address - Zip Code:76043-4937
Practice Address - Country:US
Practice Address - Phone:254-897-2415
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SOMERVELL COUNTY HOSPITAL DISTRICT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-11-21
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004860OtherFACILITY ID
TX004860OtherFACILITY ID