Organization
SOUTHWEST LTC KILGORE LTD
Active
Other names
The Willows of Kilgore
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD R PAYNE (MANAGER)
(469) 916-6100
Entity
Organization
Contact information
Practice address
1901 WHIPPORWILL LN, KILGORE, TX 75662-3880
(903) 983-7775
(903) 984-2244
Mailing address
1901 WHIPPORWILL LN, KILGORE, TX 75662-3880
(903) 983-7775
(903) 984-2244
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/18/2010
Last updated
11/08/2010
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