# PROVIDER HEALTHCARE SERVICES OF LULING, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Oakcreek Nursing and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366457723
- **Authorized official:** MR. TED MORGAN (MANAGER)
- **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:** 3420 EXECUTIVE CENTER DR, SUITE 100, AUSTIN, TX 78731-1624
- **Mailing address phone:** (512) 343-9070
- **Mailing address fax:** (512) 343-1060

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 117854 | TX | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1014325 | — | TX |