Provider Demographics
NPI:1679116354
Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Other - Org Name:BEACON HARBOR HEALTHCARE AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER OF MANAGEMENT COMPANY
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:6700 HERITAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-8748
Mailing Address - Country:US
Mailing Address - Phone:972-412-4000
Mailing Address - Fax:972-412-8366
Practice Address - Street 1:6700 HERITAGE PKWY
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-8748
Practice Address - Country:US
Practice Address - Phone:972-412-4000
Practice Address - Fax:972-412-8366
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility