Organization · Type 2 NPI

902 E Main ST Opco LLC

Skilled Nursing Facility · San Augustine, TX

NPI number 1417845207 Active

Practice location

902 E Main St
San Augustine, TX 75972-2316

Call (936) 275-2055 Map

Fax (936) 275-5658

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	None listed

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

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About NPI 1417845207

902 E Main ST Opco LLC's National Provider Identifier is 1417845207, issued on Jun 27, 2025. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in San Augustine, TX. The record was last updated on Jun 27, 2025.