# DIVERSIFIED HEALTHCARE-DALLAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Brookhaven Nursing & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093847378
- **Authorized official:** MR. TOM MARKS (ADMINISTRATOR)
- **Authorized official phone:** (972) 394-7141

## Contact information

- **Practice address:** 1855 CHEYENNE DR, CARROLLTON, TX 75010-2201
- **Practice address phone:** (972) 394-7141
- **Practice address fax:** (972) 492-5534
- **Mailing address:** 1855 CHEYENNE DR, CARROLLTON, TX 75010-2201
- **Mailing address phone:** (972) 394-7141
- **Mailing address fax:** (972) 492-5534

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 118368 | TX | Yes |

## Other

- **Enumeration date:** 03/12/2007
- **Last updated:** 08/12/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001013833 | — | TX |