Basic Information
| Provider Information | |||||||||
| NPI: | 1184656696 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | HONOR SERVICES,INC. | ||||||||
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| OtherOrganizationName: | DIMMITT NURSING AND REHABILITATION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1621 BUTLER DR | ||||||||
| Address2: | |||||||||
| City: | DIMMITT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790272701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067714124 | ||||||||
| FaxNumber: | 8067714126 | ||||||||
| Practice Location | |||||||||
| Address1: | 1621 BUTLER DR | ||||||||
| Address2: | |||||||||
| City: | DIMMITT | ||||||||
| State: | TX | ||||||||
| PostalCode: | 790272701 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8067714124 | ||||||||
| FaxNumber: | 8067714126 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | JEWEL | ||||||||
| AuthorizedOfficialFirstName: | CARMEN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8067714124 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 313M00000X | TX | Y | Nursing & Custodial Care Facilities | Nursing Facility/Intermediate Care Facility |
ID Information
| ID | Type | State | Issuer | Description | 4948 | 05 | TX | MEDICAID |