| NPI | 1174533392 |
|---|---|
| Doing Business As | FIRESIDE LODGE REHABILITATION CENTER OF CLEBURNE |
| Entity Type | Organization |
| Authorized Contact | JOHN R WILCOX President 281-363-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 112679) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2020-08-22 |