# FORT WORTH WEST SIDE LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** WEST SIDE CAMPUS OF CARE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285935650
- **Authorized official:** DR. DICK STEBBINS (MANAGER OF GENERAL PARTNER)
- **Authorized official phone:** (903) 757-5360

## Contact information

- **Practice address:** 1950 S LAS VEGAS TRL, WHITE SETTLEMENT, TX 76108-3350
- **Practice address phone:** (817) 246-4995
- **Mailing address:** 600 E WHALEY ST, LONGVIEW, TX 75601-6525
- **Mailing address phone:** (903) 757-5360
- **Mailing address fax:** (903) 753-8621

## Taxonomy

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

## Other

- **Enumeration date:** 11/16/2010
- **Last updated:** 01/03/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5204 | — | TX |