# FANNIN COUNTY HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Legend Healthcare and Rehabilitation - Greenville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114388089
- **Authorized official:** SOON BURNAM (TREASURER)
- **Authorized official phone:** (949) 540-2149

## Contact information

- **Practice address:** 2300 JACK FINNEY BLVD, GREENVILLE, TX 75402-3763
- **Practice address phone:** (903) 455-7942
- **Practice address fax:** (903) 455-0472
- **Mailing address:** 2300 JACK FINNEY BLVD, GREENVILLE, TX 75402-3763
- **Mailing address phone:** (903) 455-7942
- **Mailing address fax:** (903) 455-0472

## Taxonomy

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

## Other

- **Enumeration date:** 03/18/2016
- **Last updated:** 02/26/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1028700 | — | TX |