Provider Demographics
NPI:1497072367
Name:VAL VERDE COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:VAL VERDE COUNTY HOSPITAL DISTRICT
Other - Org Name:DEVINE HEALTH & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-775-8566
Mailing Address - Street 1:4150 INTERNATIONAL PLZ STE 600
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109-4831
Mailing Address - Country:US
Mailing Address - Phone:817-348-8959
Mailing Address - Fax:817-348-0466
Practice Address - Street 1:104 ENTERPRISE AVE
Practice Address - Street 2:
Practice Address - City:DEVINE
Practice Address - State:TX
Practice Address - Zip Code:78016-1807
Practice Address - Country:US
Practice Address - Phone:830-663-4451
Practice Address - Fax:830-663-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001018546Medicaid
TXFACILITY IDOther005007
TX001018546Medicaid