Provider Demographics
NPI:1952301657
Name:BALMORAL, LTD
Entity Type:Organization
Organization Name:BALMORAL, LTD
Other - Org Name:WINDSOR REHABILITATION & HEALTH CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:C
Authorized Official - Last Name:TUTERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:816-444-0900
Mailing Address - Street 1:250 W BRITISH FLYING SCHOOL BLVD
Mailing Address - Street 2:
Mailing Address - City:TERRELL
Mailing Address - State:TX
Mailing Address - Zip Code:75160-0043
Mailing Address - Country:US
Mailing Address - Phone:972-551-0122
Mailing Address - Fax:972-551-3307
Practice Address - Street 1:250 W BRITISH FLYING SCHOOL BLVD
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-0043
Practice Address - Country:US
Practice Address - Phone:972-551-0122
Practice Address - Fax:972-551-3307
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-26
Last Update Date:2014-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX105936314000000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4183Medicaid
TX4183Medicaid