Basic Information
| Provider Information | |||||||||
| NPI: | 1124658455 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BOERNE NURSING OPERATIONS, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 306 W 7TH ST STE 430 | ||||||||
| Address2: | |||||||||
| City: | FORT WORTH | ||||||||
| State: | TX | ||||||||
| PostalCode: | 761024902 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1102 RIVER RD | ||||||||
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| City: | BOERNE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 780062436 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8302492799 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/26/2020 | ||||||||
| LastUpdateDate: | 01/26/2020 | ||||||||
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| AuthorizedOfficialLastName: | HARRINGTON | ||||||||
| AuthorizedOfficialFirstName: | RYAN | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8173396177 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 01/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.