- Enrollment id
- O20181116000724
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1629516109
- Multiple npi flag
- N
- Ccn
- 675903
- Associate id
- 9032103700
- Organization name
- SOUTH LIMESTONE HOSPITAL DISTRICT
- Doing business as name
- MEXIA LTC NURSING AND REHABILITATION
- Organization type structure
- OTHER
- Organization other type text
- HOSPITAL DISTRICT
- Proprietary nonprofit
- N
- Nursing home provider name
- MEXIA LTC NURSING AND REHABILITATION
- Affiliation entity name
- GULF COAST LTC PARTNERS
- Affiliation entity id
- 243
- Address line 1
- 601 TERRACE LANE
- City
- MEXIA
- State
- TX
- Zip code
- 766672072