Shady Shores of Premont LLC
NPI #1881079101 in Premont, Texas
Provider Information
- NPI Number
- 1881079101
- Entity Type
- Organization
- Organization Name
- Shady Shores of Premont LLC
- Primary Specialty
- Skilled Nursing Facility
- Enumeration Date
- Jul 28, 2015
- Last Updated
- Jun 14, 2016
Practice Location
Authorized Official
- Name
- MICHAEL WALLACE
- Title
- CEO
- Phone
- (214) 422-1622
Specialties & Taxonomy Codes
| Specialty |
|---|
| Skilled Nursing Facility |
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