# WILLOW BLUFF LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Willows of Kilgore
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336124643
- **Authorized official:** MRS. SONDRA SCALCO LNFA (ADMINISTRATOR)
- **Authorized official phone:** (903) 983-7775

## Contact information

- **Practice address:** 1901 WHIPPORWILL LN, KILGORE, TX 75662-3880
- **Practice address phone:** (903) 983-7775
- **Mailing address:** 1901 WHIPPORWILL LN, KILGORE, TX 75662-3880
- **Mailing address phone:** (903) 983-7775

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 114059 | TX | Yes |

## Other

- **Enumeration date:** 12/08/2005
- **Last updated:** 08/22/2020