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Organization
ROCK CREEK HEALTH AND REHABILITATION LLC
Active
Organization
ROCK CREEK HEALTH AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL G. WALLACE (PRESIDENT)
(940) 387-4388
Entity
Organization
Contact information
Practice address
1414 COLLEGE ST, SULPHUR SPRINGS, TX 75482-3431
(903) 439-0107
(903) 439-0147
Mailing address
401 N ELM ST, DENTON, TX 76201-4137
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001020121
—
TX
01
—
295239201
MEDICAID CO B CROSS-OVER
TX
Enumeration date
11/07/2011
Last updated
07/27/2012
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