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Kilgore Manor Inc
Nursing Facility/Intermediate Care Facility in Kilgore, Texas
NPI 1447246145

Kilgore Manor Inc is a Nursing Facility/Intermediate Care Facility based in Kilgore, TX. Kilgore Manor Inc practices in Kilgore, TX. The NPI Number for Kilgore Manor Inc is 1447246145 and holds a License No. 112798 (Texas).

The current practice location address for Kilgore Manor Inc is 2700 S Henderson Blvd, Kilgore, TX and can be reached out via phone at 903-984-3511 and via fax at 903-983-1031.

Location: 2700 S Henderson Blvd, Kilgore, TX, 75662-4033
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1447246145
Provider Name
Kilgore Manor Inc
Credential
Provider Entity Type
Organization
Address
2700 S Henderson Blvd, Kilgore, TX, 75662-4033
Phone Number
903-984-3511
Fax Number
903-983-1031
Provider Enumeration Date
09/27/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00102185 05 TX
HH2539 01 TX BLUE CROSS BLUE SHIELD
0220162-01 01 TX TEXAS MEDICAID B
institution
Provider Business Practice Location Address Details
Address
2700 S Henderson Blvd
City
Kilgore
State
Texas
Zip
75662-4033
Phone Number
903-984-3511
Fax Number
903-983-1031
person
Provider Business Mailing Address Details
Address
2700 S Henderson Blvd
City
Kilgore
State
Texas
Zip
75662-4033
Phone Number
903-984-3511
Fax Number
903-983-1031
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Nursing Facility/Intermediate Care Facility
Speciality
-
Taxonomy
313M00000X
License No.
112798 (Texas)
Definition
An institution (or a distinct part of an institution) which- (1) is primarily engaged in providing to residents- (A) skilled nursing care and related services for residents who require medical or nursing care, (B) rehabilitation services for the rehabilitation of injured, disabled, or sick persons, or, on a regular basis, health-related care and services to individuals who because of their mental or physical condition require care and services (above the level of room and board) which can be made available to them only through institutional facilities, and is not primarily for the care and treatment of mental diseases; (2) has in effect a transfer agreement with one or more hospitals.
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