Organization
NORTHRIDGE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICA ANDERSON (MANAGER)
(817) 875-0864
Entity
Organization
Contact information
Practice address
1501 W 29TH ST, TYLER, TX 75702-1404
(817) 875-0864
Mailing address
1501 W 29TH ST, TYLER, TX 75702-1404
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
03/31/2014
Last updated
03/31/2014
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