- Enrollment id
- O20221012002080
- Enrollment state
- TX
- Provider type code
- 00-18
- Provider type text
- PART A PROVIDER - SKILLED NURSING FACILITY
- Npi
- 1952046732
- Multiple npi flag
- N
- Ccn
- 676166
- Associate id
- 5496653842
- Organization name
- GUADALUPE COUNTY HOSPITAL BOARD
- Doing business as name
- AVIR AT SEALY
- Organization type structure
- GOVERNMENT
- Proprietary nonprofit
- N
- Nursing home provider name
- AVIR AT SEALY
- Affiliation entity name
- AVIR HEALTH GROUP
- Affiliation entity id
- 719
- Address line 1
- 1401 EAGLE LAKE RD
- Address line 2
- AVIR AR SEALY
- City
- SEALY
- State
- TX
- Zip code
- 774743109