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Andrews County Hospital District

Organization Active NPI Nursing Facility/Intermediate Care Facility · Andrews, TX

NPI 1811051964 · NPPES record last updated Jul 31, 2026

Key facts

NPI
1811051964
Entity type
Organization (NPI type 2)
Primary specialty
Nursing Facility/Intermediate Care Facility 313M00000X
License
118750 (TX)
Legal business name
ANDREWS COUNTY HOSPITAL DISTRICT
Practice address
1601 NE Mustang Dr
Andrews, TX 79714-3647
Phone
(432) 464-2430
Fax
(432) 464-2572
NPI assigned
Dec 21, 2006
Organization subpart
Yes
Parent organization (as reported)
ANDREWS COUNTY HOSPITAL DISTRICT

Authorized official

Name
Susan Fournier
Title
Cfo
Phone
(432) 464-2107

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Owned or controlled facilities with NPI records 5

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Facilities with the same owner 5

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Medicare Care Compare: Nursing home

Listed as
Permian Residential Care Center CCN 676175
Overall star rating
★★★★★ 5 of 5
Health inspections
★★★★★ 5 of 5
Staffing
★★★★★ 5 of 5
Quality measures
★★★☆☆ 3 of 5
Type
Medicare and Medicaid
Ownership
Government - County
Certified
May 23, 2008
Medicare certification status
Active (Provider of Services file)
Certified beds
112 · 67.7 residents per day on average
Penalties (3 years)
1 · fines totaling $20,865

Source: Medicare Care Compare, processed Aug 1, 2026.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D1021350Permian Residential Care Center
1601 NE Mustang Drive, Andrews, TX 79714		Certificate of waiverJan 20, 2028

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Skilled nursing facility certification: CCN 676175

Legal name
ANDREWS COUNTY HOSPITAL DISTRICT
Doing business as
PERMIAN RESIDENTIAL CARE CENTER
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
May 23, 2008
Last certification
Sep 26, 2024
Beds
112
Ownership / control type
County
Organization structure
Other · Non-profit
Enrollment address
1601 NE Mustang Drive
Permian Residential Care Center
Andrews, TX 79714-3647
Nursing home name
PERMIAN RESIDENTIAL CARE CENTER

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Manual Gonzales
Individual 		Operational/Managerial Control Jan 1, 2017
Managing Control - Governing Body
Board Member		 Jan 1, 2017
Paul M Slaughter
Individual 		Operational/Managerial Control Feb 12, 2003
Adp of the SNF Apr 8, 2025
Donna Pryor
Individual 		Operational/Managerial Control Dec 5, 2005
Carol Boswell
Individual 		Operational/Managerial Control Feb 12, 2003
Managing Control - Governing Body
Board Member		 Feb 12, 2003
Donny Booth
Individual 		Operational/Managerial Control
Ceo		 Oct 1, 2019
Andrea Warnke
Individual 		Managing Control - Governing Body
Board Member		 Jan 1, 2018
Felicia D Jamison
Individual 		Operational/Managerial Control May 11, 2022
Martina Castillo
Individual 		Managing Control - Governing Body
Board Member		 May 1, 2024
Jessica Varner
Individual 		Operational/Managerial Control May 1, 2022
Managing Control - Governing Body
Board Member		 May 1, 2022
Andrews County Hospital District
Organization · Andrews, TX
Non-profit 		5% Or Greater Direct Ownership Interest Feb 12, 2003
Trustee of the SNF Feb 12, 2003
Adp of the SNF Feb 12, 2003
Sarah Bender
Individual 		Operational/Managerial Control Nov 1, 2023
Managing Control - Governing Body
Board Member		 Nov 1, 2023
Mike Sanchez
Individual 		Operational/Managerial Control Nov 1, 2020
Managing Control - Governing Body
Board Member		 Nov 1, 2020
Cydney Fulks
Individual 		Operational/Managerial Control Oct 1, 2022
Trustee of the SNF Oct 1, 2022
Adp of the SNF Oct 1, 2022

All facility ownership & control disclosures 5

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Permian Regional Medical Center
Andrews, TX · CCN 450144		 Hospital Operational/Managerial Control Jan 1, 2003
Permian Regional Medical Center
Andrews, TX · CCN 45U144		 Hospital Operational/Managerial Control Jan 1, 2003
Permian Regional Medical Center Home Health
Andrews, TX · CCN 457596		 Home health agency Operational/Managerial Control Nov 1, 2009
Andrews Family Medicine
Andrews, TX · CCN 458655		 Rural health clinic Operational/Managerial Control May 26, 2010
Quick Care Clinic
Andrews, TX · CCN 673420		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jun 2, 2013

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20071030000555 TX Part a Provider - Skilled Nursing Facility 6002724945 Practice locations: Andrews, TX

National Provider Directory

Tax ID family
Andrews County Hosp Dist (9 organizations share this tax ID)
Part of
Andrews County Hosp Dist

Locations

1601 NE Mustang Dr
Andrews, TX 79714
Phone (432) 464-2430

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 118750 TX Yes

Addresses

Primary practice location

1601 NE Mustang Dr
Andrews, TX 79714-3647

Mailing address

1601 NE Mustang Dr
Andrews, TX 79714-3647
Phone (432) 464-2200

Other identifiers

IdentifierTypeStateIssuer
001004526MedicaidTX

Other names

  • Permian Residential Care Center Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL https://199.119.81.30:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRResponse_Service Other eSolutions Inc.

Other providers in Andrews, TX

All providers in Andrews, TX · Nursing Facility/Intermediate Care Facility in Texas

Sources for this page

Verify at the official NPI Registry.