Provider Demographics
NPI:1598156341
Name:CHAMBERS COUNTY
Entity Type:Organization
Organization Name:CHAMBERS COUNTY
Other - Org Name:ARBORETUM NURSING AND REHABILITATION CENTER OF WINNIE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:WHITLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:361-576-9454
Mailing Address - Street 1:PO BOX 7230
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903-7230
Mailing Address - Country:US
Mailing Address - Phone:361-576-9454
Mailing Address - Fax:361-576-2994
Practice Address - Street 1:1215 HIGHWAY 124
Practice Address - Street 2:
Practice Address - City:WINNIE
Practice Address - State:TX
Practice Address - Zip Code:77665-9005
Practice Address - Country:US
Practice Address - Phone:409-296-8200
Practice Address - Fax:409-296-8212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-16
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001025803314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001026727Medicaid
TX5394Medicaid
675798Medicare Oscar/Certification