Provider Demographics
NPI:1629254578
Name:CENTURY 100 MANAGEMENT
Entity Type:Organization
Organization Name:CENTURY 100 MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:J
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-747-7272
Mailing Address - Street 1:PO BOX 98348
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79499-8348
Mailing Address - Country:US
Mailing Address - Phone:806-747-7272
Mailing Address - Fax:806-747-1033
Practice Address - Street 1:1 GOLDEN CT
Practice Address - Street 2:
Practice Address - City:ABERNATHY
Practice Address - State:TX
Practice Address - Zip Code:79311-2015
Practice Address - Country:US
Practice Address - Phone:806-298-8872
Practice Address - Fax:806-298-8872
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-10
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX121119310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility