Organization
TYLER COUNTY HOSPITAL DISTRICT
Active
Other names
Magnolia Manor
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA WILLIAMS (CEO)
(409) 283-8141
Entity
Organization
Contact information
Practice address
4400 GULF AVE, GROVES, TX 77619-3717
(409) 962-5785
Mailing address
1100 W BLUFF ST, WOODVILLE, TX 75979-4738
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45-5538
MEDICARE CCN
TX
Enumeration date
01/02/2015
Last updated
08/28/2025
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