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Organization
FT. WORTH SOUTHWEST NURSING CENTER, LLC
Active
Organization
FT. WORTH SOUTHWEST NURSING CENTER, LLC
Active
Other names
SOUTHWEST NURSING & REHABILITATION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
DICK STEBBINS CPA (MEMBER/MANAGER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
5300 ALTA MESA BLVD, FORT WORTH, TX 76133-5924
(817) 346-1800
(817) 346-0149
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
100222
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001001513
—
TX
05
—
022645801
—
TX
Enumeration date
10/10/2005
Last updated
09/13/2012
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