# EAST TEXAS LTC THE WATERTON AT SHILOH LLC

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

## Provider details

- **NPI number:** 1447525803
- **Authorized official:** CARLA POWER (CFO)
- **Authorized official phone:** (903) 792-0838

## Contact information

- **Practice address:** 2875 SHILOH RD, TYLER, TX 75703-2936
- **Practice address phone:** (903) 561-1300
- **Mailing address:** 2875 SHILOH RD, TYLER, TX 75703-2936
- **Mailing address phone:** (903) 561-1300

## Taxonomy

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

## Other

- **Enumeration date:** 03/19/2012
- **Last updated:** 06/20/2018