# PROVIDER HEALTHCARE SERVICES OF LULING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** OakCreek Nursing & Rehab
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013914191
- **Authorized official:** MR. TED MORGAN (AGENT)
- **Authorized official phone:** (512) 343-9070

## Contact information

- **Practice address:** 1105 N MAGNOLIA AVE, LULING, TX 78648-1604
- **Practice address phone:** (830) 875-5606
- **Practice address fax:** (830) 875-5857
- **Mailing address:** 1105 N MAGNOLIA AVE, P. O. BOX 1066, LULING, TX 78648-1604
- **Mailing address phone:** (830) 875-5606
- **Mailing address fax:** (830) 875-5857

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 005045 | TX | Yes |

## Other

- **Enumeration date:** 07/05/2005
- **Last updated:** 08/22/2020