# HOPKINS COUNTY HOSPITAL DISTRICT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Providence Park Rehabilitation and Skilled Nursing
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508254046
- **Authorized official:** MICHAEL MCANDREW (CEO)
- **Authorized official phone:** (903) 439-4952

## Contact information

- **Practice address:** 5505 NEW COPELAND RD, TYLER, TX 75703-3955
- **Practice address phone:** (903) 939-2443
- **Practice address fax:** (903) 939-2479
- **Mailing address:** 115 AIRPORT RD, SULPHUR SPRINGS, TX 75482-2105
- **Mailing address phone:** (903) 439-4952

## Taxonomy

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

## Other

- **Enumeration date:** 01/07/2015
- **Last updated:** 01/07/2015