Southwest Ltc - Bonner LLC
NPI #1033772413 in Jacksonville, Texas
Provider Information
- NPI Number
- 1033772413
- Entity Type
- Organization
- Organization Name
- Southwest Ltc - Bonner LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Apr 21, 2019
- Last Updated
- Apr 21, 2019
Practice Location
- Address
- 810 BELLAIRE ST
- City
- Jacksonville
- State
- Texas
- ZIP Code
- 75766-9045
- Phone
- (903) 589-5300
Authorized Official
- Name
- RONALD PAYNE
- Title
- PRESIDENT
- Phone
- (469) 916-6100
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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