# ROCK CREEK HEALTH AND REHABILITATION LLC

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

## Provider details

- **NPI number:** 1689951543
- **Authorized official:** MR. MICHAEL G. WALLACE (PRESIDENT)
- **Authorized official phone:** (940) 387-4388

## Contact information

- **Practice address:** 1414 COLLEGE ST, SULPHUR SPRINGS, TX 75482-3431
- **Practice address phone:** (903) 439-0107
- **Practice address fax:** (903) 439-0147
- **Mailing address:** 401 N ELM ST, DENTON, TX 76201-4137
- **Mailing address phone:** (940) 387-4388
- **Mailing address fax:** (940) 380-2410

## Taxonomy

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

## Other

- **Enumeration date:** 11/07/2011
- **Last updated:** 07/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001020121 | — | TX |
| 01 | — | 295239201 | MEDICAID CO B CROSS-OVER | TX |