Organization
NACOGDOCHES COUNTY HOSPITAL DISTRICT
Active
Other names
Ponderosa Nursing & Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
GARY KENDRICK (CEO)
(936) 568-8523
Entity
Organization
Contact information
Practice address
12520 FM 1840, DE KALB, TX 75559-1929
(903) 667-2572
(903) 667-5589
Mailing address
1204 N MOUND ST, NACOGDOCHES, TX 75961-4027
(936) 568-8523
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001021048
—
TX
Enumeration date
01/21/2013
Last updated
11/20/2017
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