Provider Demographics
NPI:1740307420
Name:BAPTIST COMMUNITY AFFORDABLE HOUSING FOUNDATION
Entity type:Organization
Organization Name:BAPTIST COMMUNITY AFFORDABLE HOUSING FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-457-4600
Mailing Address - Street 1:1910 MEDI PARK DR
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2104
Mailing Address - Country:US
Mailing Address - Phone:806-457-4700
Mailing Address - Fax:806-457-4608
Practice Address - Street 1:1910 MEDI PARK DR
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2104
Practice Address - Country:US
Practice Address - Phone:806-457-4700
Practice Address - Fax:806-457-4608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119655313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
Not Answered314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX676085Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER