Organization
AUTUMN LEAVES NURSING AND REHAB INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA BETH IRWIN (PRESIDENT)
(903) 657-8969
Entity
Organization
Contact information
Practice address
321 KILGORE DR, HENDERSON, TX 75652-5215
(903) 657-1923
(903) 657-6464
Mailing address
321 KILGORE DR, HENDERSON, TX 75652-5215
(903) 657-1923
(903) 657-6764
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116372
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000449901
—
TX
Enumeration date
12/12/2006
Last updated
08/21/2015
Update your record
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