Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Other names
Avir at Jefferson
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK SANDERSON (PRESIDENT)
(903) 583-1854
Entity
Organization
Contact information
Practice address
1307 MARTIN LUTHER KING DR, JEFFERSON, TX 75657-1009
(903) 665-3951
Mailing address
1307 MARTIN LUTHER KING DR, JEFFERSON, TX 75657-1009
(903) 583-8585
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029296
—
TX
Enumeration date
08/21/2015
Last updated
08/24/2025
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