Provider Demographics
NPI:1598378796
Name:WEST COKE COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:WEST COKE COUNTY HOSPITAL DISTRICT
Other - Org Name:WILLOW CREEK LODGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:HOUSTON
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGUIRE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-453-2511
Mailing Address - Street 1:11830 NORTHPOINTE BLVD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-5536
Mailing Address - Country:US
Mailing Address - Phone:281-205-9400
Mailing Address - Fax:
Practice Address - Street 1:11830 NORTHPOINTE BLVD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-5536
Practice Address - Country:US
Practice Address - Phone:281-205-9400
Practice Address - Fax:281-516-2540
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2024-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility