# MSHC BONNER STREET PLAZA LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1386936664
- **Authorized official:** CARLA POWER (CFO)
- **Authorized official phone:** (903) 792-0838

## Contact information

- **Practice address:** 421 S BONNER ST, JACKSONVILLE, TX 75766-2330
- **Practice address phone:** (903) 586-9871
- **Mailing address:** 421 BONNER STREET, JACKSONVILLE, TX 75766-2330
- **Mailing address phone:** (903) 586-9871

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 129146 | TX | Yes |

## Other

- **Enumeration date:** 05/05/2011
- **Last updated:** 07/12/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005275 | — | TX |