Organization
SALEM HOUSING CORPORATION
Active
Other names
Timberlake Health and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS K. MITTLEIDER (PRESIDENT OF MGMT CO)
(770) 619-0866
Entity
Organization
Contact information
Practice address
315 W GIBSON ST, JASPER, TX 75951-4903
(409) 384-5768
(409) 383-1940
Mailing address
5895 WINDWARD PKWY, SUITE 200, ALPHARETTA, GA 30005-5203
(770) 619-0866
(770) 870-2892
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
116446
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001013913
—
TX
Enumeration date
07/09/2006
Last updated
05/20/2010
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