# FANNIN COUNTY HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Interlochen Health and Rehabiltation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477674968
- **Authorized official:** CLARK SANDERSON (BOARD PRESIDENT)
- **Authorized official phone:** (903) 583-1854

## Contact information

- **Practice address:** 2645 W RANDOL MILL RD, ARLINGTON, TX 76012-4228
- **Practice address phone:** (817) 277-6789
- **Mailing address:** 4150 INTERNATIONAL PLZ STE 600, FORT WORTH, TX 76109-4831
- **Mailing address phone:** (817) 348-8959
- **Mailing address fax:** (817) 348-0466

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 114501 | TX | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 05/26/2023

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1028814 | — | TX |