# PARK PLAZA LTC PARTNERS, INC.

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

## Provider details

- **NPI number:** 1770727455
- **Authorized official:** MR. LOUIS FREDERICK NICHOLSON III LNFA (PRESIDENT)
- **Authorized official phone:** (832) 489-9944

## Contact information

- **Practice address:** 2210 HOWARD ST, SAN ANGELO, TX 76901-1318
- **Practice address phone:** (325) 944-0561
- **Practice address fax:** (325) 944-0562
- **Mailing address:** 2210 HOWARD ST, SAN ANGELO, TX 76901-1318
- **Mailing address phone:** (325) 944-0561
- **Mailing address fax:** (325) 944-0562

## Taxonomy

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

## Other

- **Enumeration date:** 04/27/2009
- **Last updated:** 01/14/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 004561 | FACILITY ID | TX |