Provider Demographics
NPI:1568450971
Name:HILL COUNTRY HEALTHCARE
Entity Type:Organization
Organization Name:HILL COUNTRY HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SHAW
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:325-247-4115
Mailing Address - Street 1:507 E GREEN ST
Mailing Address - Street 2:
Mailing Address - City:LLANO
Mailing Address - State:TX
Mailing Address - Zip Code:78643-2717
Mailing Address - Country:US
Mailing Address - Phone:325-247-4115
Mailing Address - Fax:325-247-3978
Practice Address - Street 1:507 E GREEN ST
Practice Address - Street 2:
Practice Address - City:LLANO
Practice Address - State:TX
Practice Address - Zip Code:78643-2717
Practice Address - Country:US
Practice Address - Phone:325-247-4115
Practice Address - Fax:325-247-3978
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110706314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility