# LEGEND OAKS - SAN ANGELO, LLC

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

## Provider details

- **NPI number:** 1720003536
- **Authorized official:** MARTIN TOMERLIN (PRESIDENT)
- **Authorized official phone:** (210) 564-0100

## Contact information

- **Practice address:** 5455 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7711
- **Practice address phone:** (325) 944-1600
- **Practice address fax:** (325) 944-1660
- **Mailing address:** 5455 KNICKERBOCKER RD, SAN ANGELO, TX 76904-7711
- **Mailing address phone:** (325) 944-1600
- **Mailing address fax:** (325) 944-1660

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 5472 | TX | Yes |

## Other

- **Enumeration date:** 07/13/2006
- **Last updated:** 10/12/2007