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Organization
AUTUMN LEAVES NURSING AND REHAB INC
Active
Organization
AUTUMN LEAVES NURSING AND REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA BETH IRWIN (PRESIDENT)
(903) 657-8969
Entity
Organization
Contact information
Practice address
321 KILGORE DR, HENDERSON, TX 75652-5215
(903) 657-1923
(903) 657-6464
Mailing address
321 KILGORE DR, HENDERSON, TX 75652-5215
(903) 657-1923
(903) 657-6764
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116372
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449901
—
TX
Enumeration date
12/12/2006
Last updated
08/21/2015
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