Organization
TEXARKANA ELDER SERVICES, INC. DBA EDGEWOOD MANOR NURSING HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KYLE MARK DESHOTELS (PRESIDENT MEMBER)
(870) 773-2376
Entity
Organization
Contact information
Practice address
4925 ELIZABETH ST, TEXARKANA, TX 75503-2911
(903) 793-4645
(903) 793-3956
Mailing address
4925 ELIZABETH ST, TEXARKANA, TX 75503-2911
(903) 793-4645
(903) 793-3956
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
113456
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005150
FACILITY #
TX
05
—
113456
—
TX
Enumeration date
10/06/2005
Last updated
06/24/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us