# BANDERA ELITE HOLDINGS, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Cedar Creek Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790921302
- **Authorized official:** UMSHAVENI GOVENDER (VICE PRESIDENT)
- **Authorized official phone:** (972) 757-5115

## Contact information

- **Practice address:** 159 MONTAGUE AVE, BANDERA, TX 78003
- **Practice address phone:** (972) 757-5115
- **Practice address fax:** (817) 590-2948
- **Mailing address:** PO BOX 185159, FORT WORTH, TX 76181-0159
- **Mailing address phone:** (972) 757-5115
- **Mailing address fax:** (817) 590-2948

## Taxonomy

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

## Other

- **Enumeration date:** 01/02/2009
- **Last updated:** 06/26/2009