MEDICARE: YARBROUGH HEALTH CARE SERVICES 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	3140N1450X	Pediatric Skilled Nursing Facility

General Provider Information

NPI Number	:	1427009414
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YARBROUGH HEALTH CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	3968 E PARK BLVD
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75074-3410
Country	:	US
Telephone Number	:	972-423-6822
Fax Number	:

Provider Business Practice Location Address
First Line	:	11247 SPUR 364
Second Line	:
City	:	TYLER
State	:	TX
Zip	:	75709-5358
Country	:	US
Telephone Number	:	903-534-3600
Fax Number	:	903-534-3925

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	WILLIE DONELL YARBROUGH
Credential	:
Telephone Number	:	972-423-6822

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	08/22/2020

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