# FANNIN COUNTY HOSPITAL AUTHORITY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Waterton Healthcare and Rehabilitation
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679225296
- **Authorized official:** SOON BURNAM (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (949) 540-1249

## Contact information

- **Practice address:** 2875 SHILOH RD, TYLER, TX 75703-2936
- **Practice address phone:** (903) 561-1300
- **Practice address fax:** (903) 939-1754
- **Mailing address:** 2875 SHILOH RD, TYLER, TX 75703-2936
- **Mailing address phone:** (903) 561-1300
- **Mailing address fax:** (903) 939-1754

## Taxonomy

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

## Other

- **Enumeration date:** 01/25/2022
- **Last updated:** 01/25/2022