Provider Demographics
NPI:1558364356
Name:B & T MANAGED CARE LLC
Entity Type:Organization
Organization Name:B & T MANAGED CARE LLC
Other - Org Name:MONAHANS MANAGED CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:F
Authorized Official - Last Name:TURNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-943-2741
Mailing Address - Street 1:1200 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:MONAHANS
Mailing Address - State:TX
Mailing Address - Zip Code:79756-8301
Mailing Address - Country:US
Mailing Address - Phone:432-943-2741
Mailing Address - Fax:
Practice Address - Street 1:1200 W 15TH ST
Practice Address - Street 2:
Practice Address - City:MONAHANS
Practice Address - State:TX
Practice Address - Zip Code:79756-8301
Practice Address - Country:US
Practice Address - Phone:432-943-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109405314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001001093Medicaid
TX5164OtherMEDICAID VENDOR NUMBER
TX001001093Medicaid