Provider Demographics
NPI:1730342197
Name:SELECT OPERATIONS OF COLLEGE STATION
Entity type:Organization
Organization Name:SELECT OPERATIONS OF COLLEGE STATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP OF CORPORATE OPERATIONS
Authorized Official - Prefix:MS
Authorized Official - First Name:CONTESSA
Authorized Official - Middle Name:A
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:1888-753-6262
Mailing Address - Street 1:1601 MEDICAL CENTER DR STE 9
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-6359
Mailing Address - Country:US
Mailing Address - Phone:888-753-6262
Mailing Address - Fax:888-753-6262
Practice Address - Street 1:1103 ROCK PRAIRIE RD
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-8344
Practice Address - Country:US
Practice Address - Phone:888-753-6262
Practice Address - Fax:888-753-6262
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-07
Last Update Date:2008-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX000727310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility