Provider Demographics
NPI:1851394605
Name:BRUNETT HEALTHCARE,INC
Entity Type:Organization
Organization Name:BRUNETT HEALTHCARE,INC
Other - Org Name:CEDAR FALLS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BURNETT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-948-6841
Mailing Address - Street 1:1908 6TH ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-2124
Mailing Address - Country:US
Mailing Address - Phone:940-322-2193
Mailing Address - Fax:
Practice Address - Street 1:1908 6TH ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-2124
Practice Address - Country:US
Practice Address - Phone:940-322-2193
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112724314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675586Medicare ID - Type UnspecifiedMCR PROVIDER