Organization
SHADY SHORES OF PREMONT LLC
Active
Other names
Premont Rehab and Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL WALLACE (CEO)
(214) 422-1622
Entity
Organization
Contact information
Practice address
431 NW 3RD ST., PREMONT, TX 78375
(361) 348-3553
Mailing address
320 EAGLE DR, SUITE 201, DENTON, TX 76201-6898
(940) 228-1414
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Enumeration date
07/28/2015
Last updated
06/14/2016
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