| NPI | 1528296662 |
|---|---|
| Doing Business As | WISTERIA PLACE NURSING & REHABILITATION CENTER |
| Entity Type | Organization |
| Authorized Contact | CARROLL BRUCE DAVIS President 325-692-6145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: TX 127499) |
| Enumeration Date | 2009-06-28 |
| Last Update Date | 2009-09-04 |