Organization
MSHC THE WATERTON AT COWHORN CREEK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLA POWER (CFO)
(903) 534-8667
Entity
Organization
Contact information
Practice address
5524 COWHORN CREEK RD, TEXARKANA, TX 75503-9101
(903) 228-1188
(903) 838-1229
Mailing address
1901 RICKETY LN, STE 208, TYLER, TX 75703-1703
(903) 534-8667
(903) 509-0026
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115905
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013766
—
TX
Enumeration date
12/28/2006
Last updated
09/13/2010
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