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Organization
FORT WORTH NURSING & REHABILITATION CENTER
Active
Organization
FORT WORTH NURSING & REHABILITATION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DICK STEBBINS CPA (PRESIDENT OF GENERAL PARTNER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
1000 6TH AVE, FORT WORTH, TX 76104-2808
(817) 336-2586
(817) 336-6620
Mailing address
600 E WHALEY ST, LONGVIEW, TX 75601-6525
(903) 757-5360
(903) 753-8621
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
109618
TX
332BN1400X
Nursing Facility Supplies (DME)
109618
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
109618
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000400403
—
TX
05
—
094414201
—
TX
05
—
094414202
—
TX
05
—
HO4554608
—
TX
Enumeration date
10/10/2005
Last updated
06/25/2008
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