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Organization
MSHC THE WATERTON AT COWHORN CREEK, LLC
Active
Organization
MSHC THE WATERTON AT COWHORN CREEK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA POWER (CFO)
(903) 534-8667
Entity
Organization
Contact information
Practice address
5524 COWHORN CREEK RD, TEXARKANA, TX 75503-9101
(903) 228-1188
(903) 838-1229
Mailing address
1901 RICKETY LN, STE 208, TYLER, TX 75703-1703
(903) 534-8667
(903) 509-0026
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013766
—
TX
Enumeration date
12/28/2006
Last updated
09/13/2010
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