Organization
ROCK CREEK HEALTH AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL G. WALLACE (PRESIDENT)
(940) 387-4388
Entity
Organization
Contact information
Practice address
1414 COLLEGE ST, SULPHUR SPRINGS, TX 75482-3431
(903) 439-0107
(903) 439-0147
Mailing address
401 N ELM ST, DENTON, TX 76201-4137
(940) 387-4388
(940) 380-2410
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001020121
—
TX
01
—
295239201
MEDICAID CO B CROSS-OVER
TX
Enumeration date
11/07/2011
Last updated
07/27/2012
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