Organization
CEDAR MANOR NURSING & REHAB CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MYATT (OWNER)
(817) 573-1251
Entity
Organization
Contact information
Practice address
1915 GREENWOOD ST, SAN ANGELO, TX 76901-1112
(325) 942-0677
(325) 942-1331
Mailing address
1915 GREENWOOD ST, SAN ANGELO, TX 76901-1112
(325) 942-0677
(325) 942-1331
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
114454
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013499
—
TX
Enumeration date
01/16/2006
Last updated
12/05/2008
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