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Organization
LS VERNON OPERATOR LLC
Active
Organization
LS VERNON OPERATOR LLC
Active
Other names
Willow Creek Healthcare Centre
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LAZAR (AUTHORIZED REPRESENTATIVE)
(323) 651-1808
Entity
Organization
Contact information
Practice address
501 YATES ST, MOUNT VERNON, TX 75457-3233
(903) 537-4424
(903) 537-3427
Mailing address
501 YATES ST, MOUNT VERNON, TX 75457-3233
(903) 537-4424
(903) 597-3427
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
02/06/2019
Last updated
10/09/2020
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