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Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Other names
Reunion Plaza Senior Care and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DENVER SHEDDY (BOARD REPRESENTATIVE)
(817) 372-7224
Entity
Organization
Contact information
Practice address
1401 HAMPTON RD, TEXARKANA, TX 75503-4600
(903) 792-7994
(903) 792-8583
Mailing address
1500 WATERS RIDGE DR, SUITE 200, LEWISVILLE, TX 75057-6011
(972) 899-4401
(972) 899-4460
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002758
—
TX
01
—
150238701
MEDICAID CO B
TX
Enumeration date
09/08/2005
Last updated
02/08/2022
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