Provider Demographics
NPI:1659475051
Name:FISHER COUNTY HEALTH CARE DEVELOPMENT CORPORATION
Entity Type:Organization
Organization Name:FISHER COUNTY HEALTH CARE DEVELOPMENT CORPORATION
Other - Org Name:HERITAGE HOUSE ON THE BRAZOS ASSISTED LIVING FACILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:DEBBIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:HULL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-735-2256
Mailing Address - Street 1:776 STATE HIGHWAY 70 N
Mailing Address - Street 2:
Mailing Address - City:ROTAN
Mailing Address - State:TX
Mailing Address - Zip Code:79546-6918
Mailing Address - Country:US
Mailing Address - Phone:325-735-2256
Mailing Address - Fax:325-735-3070
Practice Address - Street 1:776 STATE HIGHWAY 70 N
Practice Address - Street 2:
Practice Address - City:ROTAN
Practice Address - State:TX
Practice Address - Zip Code:79546-6918
Practice Address - Country:US
Practice Address - Phone:325-735-2256
Practice Address - Fax:325-735-3070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114426310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility