Organization
TERRY HAVEN NURSING AND REHABILITATION LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL A RICH (PRESIDENT)
(940) 387-4388
Entity
Organization
Contact information
Practice address
424 US 67 WEST, MT VERNON, TX 75457-0519
(903) 537-4332
(903) 537-4865
Mailing address
401 N ELM ST, DENTON, TX 76201-4137
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110278
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001004516
—
TX
01
—
0945248-03
TMHP (CROSS-OVER)
TX
01
—
1564700-01
TMHP (DME CROSS-OVER)
TX
Enumeration date
10/03/2005
Last updated
07/24/2008
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