# COPPER CREEK NURSING & REHAB, INC

> 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. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1730151341
- **Authorized official:** GARY R TREBERT (CEO)
- **Authorized official phone:** (817) 359-2000

## Contact information

- **Practice address:** 302 PEARLSTONE, DRAWER M, BUFFALO, TX 75831
- **Practice address phone:** (903) 322-4208
- **Practice address fax:** (903) 322-3874
- **Mailing address:** PO BOX 155635, FORT WORTH, TX 76155-0635
- **Mailing address phone:** (817) 359-2000
- **Mailing address fax:** (817) 359-2093

## Taxonomy

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

## Other

- **Enumeration date:** 02/07/2006
- **Last updated:** 08/22/2020