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Organization
SALEM HOUSING CORPORATION
Active
Organization
SALEM HOUSING CORPORATION
Active
Other names
Timberlake Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS K. MITTLEIDER (PRESIDENT OF MGMT CO)
(770) 619-0866
Entity
Organization
Contact information
Practice address
315 W GIBSON ST, JASPER, TX 75951-4903
(409) 384-5768
(409) 383-1940
Mailing address
5895 WINDWARD PKWY, SUITE 200, ALPHARETTA, GA 30005-5203
(770) 619-0866
(770) 870-2892
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116446
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013913
—
TX
Enumeration date
07/09/2006
Last updated
05/20/2010
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