# CEDAR CREEK NURSING AND REHABILITATION CENTER, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1487626099
- **Authorized official:** UMSHAVENI GOVENDER (VICE PRESIDENT)
- **Authorized official phone:** (972) 757-5115

## Contact information

- **Practice address:** 159 MONTAGUE DRIVE, BANDERA, TX 78003
- **Practice address phone:** (830) 460-3767
- **Practice address fax:** (830) 796-4791
- **Mailing address:** PO BOX 185159, FORT WORTH, TX 76181-0159
- **Mailing address phone:** (972) 757-5115
- **Mailing address fax:** (817) 284-0409

## Taxonomy

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

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 06/13/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001012682 | — | TX |