- Enrollment id
- O20110928000784
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1881974319
- Multiple npi flag
- N
- Ccn
- 675210
- Associate id
- 0749451466
- Organization name
- ROSEBUD I ENTERPRISES, LLC
- Doing business as name
- HERITAGE HOUSE NURSING AND REHABILITATION
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Nursing home provider name
- HERITAGE HOUSE NURSING AND REHABILITATION
- Affiliation entity name
- CREATIVE SOLUTIONS IN HEALTHCARE
- Affiliation entity id
- 169
- Address line 1
- 407 N COLLEGE
- City
- ROSEBUD
- State
- TX
- Zip code
- 765702292