Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
TEXARKANA ELDER SERVICES, INC. DBA EDGEWOOD MANOR NURSING HOME
Active
Organization
TEXARKANA ELDER SERVICES, INC. DBA EDGEWOOD MANOR NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE MARK DESHOTELS (PRESIDENT MEMBER)
(870) 773-2376
Entity
Organization
Contact information
Practice address
4925 ELIZABETH ST, TEXARKANA, TX 75503-2911
(903) 793-4645
(903) 793-3956
Mailing address
4925 ELIZABETH ST, TEXARKANA, TX 75503-2911
(903) 793-4645
(903) 793-3956
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
113456
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005150
FACILITY #
TX
05
—
113456
—
TX
Enumeration date
10/06/2005
Last updated
06/24/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign upProduct
Developers