Provider Demographics
NPI:1942539820
Name:ALDERSGATE ENRICHMENT CENTER
Entity Type:Organization
Organization Name:ALDERSGATE ENRICHMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:355-646-5608
Mailing Address - Street 1:PO BOX 1406
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76804-1406
Mailing Address - Country:US
Mailing Address - Phone:325-646-5608
Mailing Address - Fax:325-643-6333
Practice Address - Street 1:5001 HIGHWAY 183/84 EAST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76804
Practice Address - Country:US
Practice Address - Phone:325-646-5608
Practice Address - Fax:325-643-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-23
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility