# NE HEALTH OF GRAPEVINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124622451
- **Authorized official:** SIOBAUGHN FRASER (AUTHORIZED REPRESENTATIVE)
- **Authorized official phone:** (561) 801-4235

## Contact information

- **Practice address:** 3729 IRA E WOODS AVE, GRAPEVINE, TX 76051-4213
- **Practice address phone:** (817) 809-8000
- **Mailing address:** 784 US HIGHWAY 1 STE 200, NORTH PALM BEACH, FL 33408-4415
- **Mailing address phone:** (561) 801-4235

## Taxonomy

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

## Other

- **Enumeration date:** 11/27/2020
- **Last updated:** 11/27/2020