Provider Demographics
NPI:1710977707
Name:HEALTH SELECT INC.
Entity Type:Organization
Organization Name:HEALTH SELECT INC.
Other - Org Name:DBA PECOS NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARANNA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEATON
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA, LBSW
Authorized Official - Phone:432-447-2183
Mailing Address - Street 1:1819 S MEMORIAL DR
Mailing Address - Street 2:P.O. BOX 1461
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-7036
Mailing Address - Country:US
Mailing Address - Phone:432-447-2183
Mailing Address - Fax:432-447-6053
Practice Address - Street 1:1819 S MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-7036
Practice Address - Country:US
Practice Address - Phone:432-447-2183
Practice Address - Fax:432-447-6053
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-21
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114047314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675881Medicare Oscar/Certification