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Organization

CRESTCARE NURSING & REHABILITATION CENTER

Active
Other names
Eden Specialty Care
Organization subpart
No

Provider details

NPI number
Authorized official
MR. LEROY WILLIAMS (PRESIDENT)
(281) 574-7495
Entity
Organization

Contact information

Practice address
1301 EDEN DR, LONGVIEW, TX 75605-4102
(903) 753-7651
(903) 758-8942
Mailing address
1301 EDEN DR, LONGVIEW, TX 75605-4102
(903) 753-7651
(903) 758-8942

Taxonomy

Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
110571
TX
314000000X
Skilled Nursing Facility
Primary
110571
TX
385H00000X
Respite Care
110571
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001003848
TX
05
1668709-01
TX
Enumeration date
10/27/2005
Last updated
07/02/2013
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