- Enrollment id
- O20230714002875
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1841995339
- Multiple npi flag
- N
- Ccn
- 675835
- Associate id
- 6103739222
- Organization name
- BAYLOR COUNTY HOSPITAL DISTRICT
- Doing business as name
- CHEROKEE TRAILS NURSING HOME
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- CHEROKEE TRAILS NURSING HOME
- Address line 1
- 330 BAGLEY RD
- City
- RUSK
- State
- TX
- Zip code
- 757851930