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Organization
SHADY SHORES OF PREMONT LLC
Active
Organization
SHADY SHORES OF PREMONT LLC
Active
Other names
Premont Rehab and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WALLACE (CEO)
(214) 422-1622
Entity
Organization
Contact information
Practice address
431 NW 3RD ST., PREMONT, TX 78375
(361) 348-3553
Mailing address
320 EAGLE DR, SUITE 201, DENTON, TX 76201-6898
(940) 228-1414
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Enumeration date
07/28/2015
Last updated
06/14/2016
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