Mulberry Manor LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MULBERRY MANOR LLC

Doing business as

Mulberry Manor

Practice address

1670 W Lingleville Rd
Stephenville, TX 76401-1830

Phone

(254) 968-2158

NPI assigned

Nov 17, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Donna Hutcheson

Title

Vice President

Phone

(254) 968-2158

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Mulberry Manor Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234224000000",
    "number": "1295809853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 RIDGEBROOK RD",
            "city": "SPARKS",
            "state": "MD",
            "postal_code": "211529390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 W LINGLEVILLE RD",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764011830",
            "telephone_number": "254-968-2158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MULBERRY MANOR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2009-02-10",
        "status": "A",
        "authorized_official_last_name": "HUTCHESON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "254-968-2158"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001014696",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mulberry Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jeffrey Moore, M.D.
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• Katherine Jones Muir, MA,CCC-A
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• Dustin Navarro, D.M.D

• Skilled Nursing Facility in Stephenville, TX
• Providers in Stephenville, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.