Provider Demographics
NPI:1669862876
Name:MCCULLOCH COUNTY HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:MCCULLOCH COUNTY HOSPITAL DISTRICT
Other - Org Name:ROSEWOOD REHABILITATION AND CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:S
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-597-2901
Mailing Address - Street 1:7700 MESQUITE PASS
Mailing Address - Street 2:
Mailing Address - City:CONVERSE
Mailing Address - State:TX
Mailing Address - Zip Code:78109-2461
Mailing Address - Country:US
Mailing Address - Phone:210-650-0551
Mailing Address - Fax:210-650-4472
Practice Address - Street 1:7700 MESQUITE PASS
Practice Address - Street 2:
Practice Address - City:CONVERSE
Practice Address - State:TX
Practice Address - Zip Code:78109-2461
Practice Address - Country:US
Practice Address - Phone:210-650-0551
Practice Address - Fax:210-650-4472
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-26
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX005343Medicaid
TX675452Medicare Oscar/Certification