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Organization
PARK PLAZA LTC PARTNERS, INC.
Active
Organization
PARK PLAZA LTC PARTNERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LOUIS FREDERICK NICHOLSON III LNFA (PRESIDENT)
(832) 489-9944
Entity
Organization
Contact information
Practice address
2210 HOWARD ST, SAN ANGELO, TX 76901-1318
(325) 944-0561
(325) 944-0562
Mailing address
2210 HOWARD ST, SAN ANGELO, TX 76901-1318
(325) 944-0561
(325) 944-0562
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004561
FACILITY ID
TX
Enumeration date
04/27/2009
Last updated
01/14/2015
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