# GREGG HOME FOR THE AGED, INC

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

## Provider details

- **NPI number:** 1649353814
- **Authorized official:** MRS. WENDY P. MOON LNHA (ADMINISTRATOR)
- **Authorized official phone:** (903) 984-5688

## Contact information

- **Practice address:** 144 FM 1252 W, KILGORE, TX 75662-5093
- **Practice address phone:** (903) 984-5688
- **Practice address fax:** (903) 984-8010
- **Mailing address:** 144 FM 1252 W, KILGORE, TX 75662-5093
- **Mailing address phone:** (903) 984-5688
- **Mailing address fax:** (903) 984-8010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 313M00000X | Nursing Facility/Intermediate Care Facility | 116795 | TX | Yes |

## Other

- **Enumeration date:** 10/23/2006
- **Last updated:** 08/22/2020