# SEAGO HEALTH CARE CENTER LTD. CO

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Manor at Seagoville
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124014428
- **Authorized official:** MRS. ROBIN UNDERHILL (CHIEF EXECUTIVE)
- **Authorized official phone:** (214) 954-4114

## Contact information

- **Practice address:** 2416 ELIZABETH LN, SEAGOVILLE, TX 75159-2702
- **Practice address phone:** (972) 287-2491
- **Practice address fax:** (972) 287-6693
- **Mailing address:** 2537 GOLDEN BEAR DR, DALLAS, TX 75006-2377
- **Mailing address phone:** (214) 954-4114
- **Mailing address fax:** (214) 871-3057

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 109485 | TX | Yes |
| 332BP3500X | Parenteral & Enteral Nutrition Supplies (DME) | — | TX | — |

## Other

- **Enumeration date:** 09/22/2005
- **Last updated:** 09/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001004490 | — | TX |
| 05 | — | 159098601 | — | TX |
| 01 | — | HH284S | BLUE CROSS | TX |