Organization
PARK PLACE TYLER HC, LLC
Active
Other names
PARK PLACE NURSING & REHAB
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHARON KAY REDD (REIMBURSEMENT SPECIALISTS)
(903) 881-9432
Entity
Organization
Contact information
Practice address
2450 E 5TH ST, TYLER, TX 75701-3525
(903) 592-6745
(903) 592-1088
Mailing address
2450 E 5TH ST, TYLER, TX 75701-3525
(903) 592-6745
(903) 592-1088
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012142
—
TX
05
—
5390
—
TX
Enumeration date
12/31/2009
Last updated
12/31/2009
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