MOUNT MORIAH HEALTH AND REHABILITATION, LLC - NPI NUMBER 1518305952

Summary

Provider Name: MOUNT MORIAH HEALTH AND REHABILITATION, LLC

NPI Number: 1518305952

Clasification: Skilled Nursing Facility (314000000X)

Address:
355 FM 83
HEMPHILL, TX
ZIP 75948

Phone Number: (940) 387-4388



Detailed Information

MOUNT MORIAH HEALTH AND REHABILITATION, LLC is a skilled nursing facility in Hemphill, TX. The provider is (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. The assigned NPI number for this provider is 1518305952 and is registered as an organization entity type.

The provider's business address is:

355 FM 83
HEMPHILL, TX
ZIP 75948
Phone: (940) 387-4388
Fax: (940) 380-2410

The provider's authorized official is Michael G. Wallace .
The authorized official title is President and has the following contact phone number (940) 387-4388.

The enumeration date for this NPI number is 6/7/2013 and was last updated on 4/7/2014.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 314000000X Skilled Nursing Facility Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 001021281 MEDICAID TX

NPI Record

No. Field Name Field Value
1 NPI 1518305952
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name MOUNT MORIAH HEALTH AND REHABILITATION, LLC
5 Provider First Line Business Practice Location Address 355 FM 83
6 Provider Business Practice Location Address City Name HEMPHILL
7 Provider Business Practice Location Address State Name TX
8 Provider Business Practice Location Address Postal Code 75948
9 Provider Business Practice Location Address Country Code If outside U S US
10 Provider Business Practice Location Address Telephone Number 9403874388
11 Provider Business Practice Location Address Fax Number 9403802410
12 Provider Enumeration Date 6/7/2013
13 Last Update Date 4/7/2014
14 Authorized Official Last Name WALLACE
15 Authorized Official First Name MICHAEL
16 Authorized Official Middle Name G.
17 Authorized Official Title or Position PRESIDENT
18 Authorized Official Telephone Number 9403874388
19 Healthcare Provider Taxonomy Code 1 314000000X
20 Healthcare Provider Primary Taxonomy Switch 1 Y
21 Other Provider Identifier 1 001021281
22 Other Provider Identifier Type Code 1 05
23 Other Provider Identifier State 1 TX
24 Is Organization Subpart N
25 Authorized Official Name Prefix Text MR.

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.