Granger Villa Inc

Organization Active NPI Skilled Nursing Facility · Granger, TX

NPI 1780765131 · NPPES record last updated Jun 28, 2013

Key facts

NPI
1780765131
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
118542 (TX)
Legal business name
GRANGER VILLA INC
Practice address
800 N Commerce
Granger, TX 76530-0398
Phone
(512) 859-2800
Fax
(512) 859-2905
NPI assigned
Oct 18, 2006
Organization subpart
No

Authorized official

Name
Mr. Joseph S Bartosh
Title
President
Phone
(512) 964-7053

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 118542 TX Yes

Addresses

Primary practice location

800 N Commerce
Granger, TX 76530-0398

Mailing address

PO Box 398
Granger, TX 76530-0398
Phone (512) 859-2800

Other identifiers

IdentifierTypeStateIssuer
001003004MedicaidTX

Other providers in Granger, TX

All providers in Granger, TX · Skilled Nursing Facility in Texas

Sources for this page

Verify at the official NPI Registry.