# SOUTHWEST LTC - REUNION PLAZA LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Reunion Plaza Healthcare & Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629493028
- **Authorized official:** RONALD PAYNE (MANAGER)
- **Authorized official phone:** (469) 916-6100

## Contact information

- **Practice address:** 1401 RICE RD, TYLER, TX 75703-3233
- **Practice address phone:** (903) 561-6060
- **Practice address fax:** (903) 534-8045
- **Mailing address:** 5560 TENNYSON PKWY STE 210, PLANO, TX 75024-3582
- **Mailing address phone:** (469) 916-6100
- **Mailing address fax:** (469) 916-6105

## Taxonomy

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

## Other

- **Enumeration date:** 02/22/2014
- **Last updated:** 02/08/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 005461 | — | TX |