# MSPF II GRANBURY O.E., L.P.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harbor Lakes Plaza Nursing and Rehabilitation Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558539205
- **Authorized official:** DAVID RONCK (PRESIDENT)
- **Authorized official phone:** (214) 651-4050

## Contact information

- **Practice address:** 1300 2ND ST, GRANBURY, TX 76048-1496
- **Practice address phone:** (817) 408-3800
- **Practice address fax:** (817) 573-0165
- **Mailing address:** 3811 TURTLE CREEK BLVD, SUITE 1850, DALLAS, TX 75219-4402
- **Mailing address phone:** (214) 651-4050
- **Mailing address fax:** (214) 651-4001

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 124179 | TX | Yes |

## Other

- **Enumeration date:** 02/15/2008
- **Last updated:** 11/14/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001016065 | — | TX |
| 01 | — | 103435 | DADS FACILITY ID | TX |