Provider Demographics
NPI:1649468422
Name:SUE D. RHINEHART
Entity type:Organization
Organization Name:SUE D. RHINEHART
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:D
Authorized Official - Last Name:RHINEHART
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-874-5000
Mailing Address - Street 1:216 E 4TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARENDON
Mailing Address - State:TX
Mailing Address - Zip Code:79226-6102
Mailing Address - Country:US
Mailing Address - Phone:806-874-5000
Mailing Address - Fax:
Practice Address - Street 1:216 E 4TH ST
Practice Address - Street 2:
Practice Address - City:CLARENDON
Practice Address - State:TX
Practice Address - Zip Code:79226-6102
Practice Address - Country:US
Practice Address - Phone:806-874-5000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-05
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146016OtherTEXAS HEALTH AND HUMAN SERVICES