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Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Other names
Lakeshore Village Nursing and Rehabilitation.
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK SANDERSON (BOARD PRESIDENT)
(817) 372-7224
Entity
Organization
Contact information
Practice address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Mailing address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
118078
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013373
—
TX
Enumeration date
04/02/2007
Last updated
06/15/2025
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