# SOUTHWEST LTC KELLER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Heritage House of Keller Health & Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376837138
- **Authorized official:** RONALD R PAYNE (MANAGER)
- **Authorized official phone:** (469) 916-6100

## Contact information

- **Practice address:** 1150 WHITLEY RD, KELLER, TX 76248-3038
- **Practice address phone:** (817) 431-2518
- **Practice address fax:** (469) 916-6105
- **Mailing address:** 1150 WHITLEY RD, KELLER, TX 76248-3038
- **Mailing address phone:** (817) 431-2518
- **Mailing address fax:** (469) 916-6105

## Taxonomy

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

## Other

- **Enumeration date:** 06/08/2011
- **Last updated:** 11/29/2012