Provider Demographics
NPI:1922065655
Name:NEXION HEALTH AT SOUTHWOOD INC
Entity Type:Organization
Organization Name:NEXION HEALTH AT SOUTHWOOD INC
Other - Org Name:FAIR PARK HEALTHCARE AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:KIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-552-4800
Mailing Address - Street 1:6937 WARFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:SYKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21784-7454
Mailing Address - Country:US
Mailing Address - Phone:410-552-4800
Mailing Address - Fax:410-552-4837
Practice Address - Street 1:701 FAIR PARK DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:TX
Practice Address - Zip Code:75654-3207
Practice Address - Country:US
Practice Address - Phone:903-657-6506
Practice Address - Fax:903-655-8578
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEXION HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-04-27
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004912314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001013846Medicaid
675983Medicare Oscar/Certification