Provider Demographics
NPI:1992832182
Name:WICHITA FALLS CARE CENTER INC
Entity Type:Organization
Organization Name:WICHITA FALLS CARE CENTER INC
Other - Org Name:WICHITA FALLS CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BETTYE
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:JEFFERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:405-476-6249
Mailing Address - Street 1:1501 7TH STREET
Mailing Address - Street 2:
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76301-3103
Mailing Address - Country:US
Mailing Address - Phone:940-322-0741
Mailing Address - Fax:940-322-1845
Practice Address - Street 1:1501 7TH STREET
Practice Address - Street 2:
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-3103
Practice Address - Country:US
Practice Address - Phone:940-322-0741
Practice Address - Fax:940-322-1845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1168453140N1450X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3140N1450XNursing & Custodial Care FacilitiesSkilled Nursing FacilityNursing Care, Pediatric