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Organization

FANNIN COUNTY HOSPITAL AUTHORITY

Active
Other names
Lakeshore Village Nursing and Rehabilitation.
Organization subpart
No

Provider details

NPI number
Authorized official
CLARK SANDERSON (BOARD PRESIDENT)
(817) 372-7224
Entity
Organization

Contact information

Practice address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075
Mailing address
2320 LAKE SHORE DR, WACO, TX 76708-1276
(254) 752-1075

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
118078
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001013373
TX
Enumeration date
04/02/2007
Last updated
06/15/2025
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