Provider Demographics
NPI:1851722359
Name:PROMISE SKILLED NURSING FACILITY OF WICHITA FALLS INC.
Entity Type:Organization
Organization Name:PROMISE SKILLED NURSING FACILITY OF WICHITA FALLS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:561-869-3100
Mailing Address - Street 1:999 YAMATO RD
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4477
Mailing Address - Country:US
Mailing Address - Phone:561-869-3100
Mailing Address - Fax:561-826-0171
Practice Address - Street 1:1101 GRACE ST
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4414
Practice Address - Country:US
Practice Address - Phone:940-720-6633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMISE HEALTHCARE #2 INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-12-09
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility