Organization
FANNIN COUNTY HOSPITAL AUTHORITY
Active
Other names
Reunion Plaza Senior Care and Rehabilitation Center
Organization subpart
No
Provider details
NPI number
Authorized official
DENVER SHEDDY (BOARD REPRESENTATIVE)
(817) 372-7224
Entity
Organization
Contact information
Practice address
1401 HAMPTON RD, TEXARKANA, TX 75503-4600
(903) 792-7994
(903) 792-8583
Mailing address
1500 WATERS RIDGE DR, SUITE 200, LEWISVILLE, TX 75057-6011
(972) 899-4401
(972) 899-4460
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
115696
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002758
—
TX
01
—
150238701
MEDICAID CO B
TX
Enumeration date
09/08/2005
Last updated
02/08/2022
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