- Enrollment id
- O20150716001492
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1497172514
- Multiple npi flag
- N
- Ccn
- 455744
- Associate id
- 4688801715
- Organization name
- STEPHENS MEMORIAL HOSPITAL DISTRICT
- Doing business as name
- AVIR AT STEPHENVILLE
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- AVIR AT STEPHENVILLE
- Affiliation entity name
- AVIR HEALTH GROUP
- Affiliation entity id
- 719
- Address line 1
- 1670 W LINGLEVILLE RD
- City
- STEPHENVILLE
- State
- TX
- Zip code
- 764011830