Provider Demographics
NPI:1902866346
Name:DS HEALTH DEVELOPMENT
Entity Type:Organization
Organization Name:DS HEALTH DEVELOPMENT
Other - Org Name:PILOT POINT CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:STERLIN
Authorized Official - Last Name:BALLOU
Authorized Official - Suffix:
Authorized Official - Credentials:LNFA
Authorized Official - Phone:940-686-5507
Mailing Address - Street 1:208 N PRAIRIE ST
Mailing Address - Street 2:P.O. BOX 1256
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-4057
Mailing Address - Country:US
Mailing Address - Phone:940-686-5507
Mailing Address - Fax:940-686-0401
Practice Address - Street 1:208 N PRAIRIE ST
Practice Address - Street 2:
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-4057
Practice Address - Country:US
Practice Address - Phone:940-686-5507
Practice Address - Fax:940-686-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114470314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675902Medicare ID - Type Unspecified