Provider Demographics
NPI:1851907711
Name:RESIDENCE AT WINTERS LLC
Entity Type:Organization
Organization Name:RESIDENCE AT WINTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOCHUM
Authorized Official - Middle Name:
Authorized Official - Last Name:FEDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-754-5083
Mailing Address - Street 1:616 E TRUETT ST
Mailing Address - Street 2:
Mailing Address - City:WINTERS
Mailing Address - State:TX
Mailing Address - Zip Code:79567-4527
Mailing Address - Country:US
Mailing Address - Phone:325-754-5083
Mailing Address - Fax:325-754-4570
Practice Address - Street 1:616 E TRUETT ST
Practice Address - Street 2:
Practice Address - City:WINTERS
Practice Address - State:TX
Practice Address - Zip Code:79567-4527
Practice Address - Country:US
Practice Address - Phone:325-754-5083
Practice Address - Fax:325-754-4570
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility