MEDICARE: REUNION INN ASSISTED LIVING LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1114895562
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REUNION INN ASSISTED LIVING LLC

Provider Business Mailing Address
First Line	:	1515 RICE RD
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-3225
Country	:	US
Telephone Number	:	954-702-3000
Fax Number	:

Provider Business Practice Location Address
First Line	:	1515 RICE RD
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75703-3225
Country	:	US
Telephone Number	:	954-702-3000
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	ASHOK GUPTA
Credential	:
Telephone Number	:	954-702-3000

Provider Enumeration Date	:	10/27/2025
Last Update Date	:	06/02/2026

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