Provider Demographics
NPI:1710318316
Name:GONZALES HEALTHCARE SYSTEMS
Entity Type:Organization
Organization Name:GONZALES HEALTHCARE SYSTEMS
Other - Org Name:THE HEIGHTS OF GONZALES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:BRANDON
Authorized Official - Middle Name:
Authorized Official - Last Name:ANZALDUA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-672-7581
Mailing Address - Street 1:1110 N SARAH DEWITT DR
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:TX
Mailing Address - Zip Code:78629-3311
Mailing Address - Country:US
Mailing Address - Phone:830-672-7581
Mailing Address - Fax:830-672-2401
Practice Address - Street 1:701 N SARAH DEWITT DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629-2813
Practice Address - Country:US
Practice Address - Phone:830-672-4530
Practice Address - Fax:830-672-4543
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-06
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001025657OtherSTATE LI
TX001025657OtherSTATE LI