Provider Demographics
NPI:1780681007
Name:SENIOR HEALTH - CROSBYTON, LLC
Entity Type:Organization
Organization Name:SENIOR HEALTH - CROSBYTON, LLC
Other - Org Name:CROSBYTON NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:ELIESE
Authorized Official - Last Name:HANLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA, MBA
Authorized Official - Phone:806-675-2342
Mailing Address - Street 1:222 N FARMER ST
Mailing Address - Street 2:
Mailing Address - City:CROSBYTON
Mailing Address - State:TX
Mailing Address - Zip Code:79322-2223
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:222 N FARMER ST
Practice Address - Street 2:
Practice Address - City:CROSBYTON
Practice Address - State:TX
Practice Address - Zip Code:79322-2223
Practice Address - Country:US
Practice Address - Phone:806-675-2342
Practice Address - Fax:806-675-2258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-01
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX9241314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675291Medicare Oscar/Certification