Provider Demographics
NPI:1700813268
Name:NOCONA-HENRIETTA HEALTH PROPERTIES INC
Entity Type:Organization
Organization Name:NOCONA-HENRIETTA HEALTH PROPERTIES INC
Other - Org Name:HORIZON MANOR NURSING HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLSTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-448-3700
Mailing Address - Street 1:1523 EAST HWY 82
Mailing Address - Street 2:P.O. BOX 449
Mailing Address - City:NOCONA
Mailing Address - State:TX
Mailing Address - Zip Code:76255
Mailing Address - Country:US
Mailing Address - Phone:940-825-3258
Mailing Address - Fax:940-825-3026
Practice Address - Street 1:1523 E HWY 82
Practice Address - Street 2:
Practice Address - City:NOCONA
Practice Address - State:TX
Practice Address - Zip Code:76255
Practice Address - Country:US
Practice Address - Phone:940-825-3258
Practice Address - Fax:940-925-3026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116476314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
455863Medicare ID - Type Unspecified