Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Other names
Interlochen Health and Rehabiltation Center
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK SANDERSON (BOARD PRESIDENT)
(903) 583-1854
Entity
Organization
Contact information
Practice address
2645 W RANDOL MILL RD, ARLINGTON, TX 76012-4228
(817) 277-6789
Mailing address
4150 INTERNATIONAL PLZ STE 600, FORT WORTH, TX 76109-4831
(817) 348-8959
(817) 348-0466
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
114501
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1028814
—
TX
Enumeration date
04/02/2007
Last updated
05/26/2023
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