# LEGEND HEALTHCARE GLADEWATER, LP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Legend Oaks Healthcare and Rehab Ctr - Gladewater
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508953399
- **Authorized official:** MARTIN TOMERLIN (PRESIDENT)
- **Authorized official phone:** (210) 564-0100

## Contact information

- **Practice address:** 1201 FM 2685, GLADEWATER, TX 75647
- **Practice address phone:** (903) 845-2175
- **Practice address fax:** (903) 844-2435
- **Mailing address:** 1390 E BITTERS RD, SAN ANTONIO, TX 78216-2914
- **Mailing address phone:** (210) 564-0100
- **Mailing address fax:** (210) 564-0157

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 5326 | TX | Yes |

## Other

- **Enumeration date:** 10/05/2006
- **Last updated:** 03/25/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001012874 | — | TX |