# CLYDE SNF LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Clyde Nursing Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609102185
- **Authorized official:** ZEVI KOHN (CFO)
- **Authorized official phone:** (917) 370-9063

## Contact information

- **Practice address:** 806 STEPHENS ST, CLYDE, TX 79510-4554
- **Practice address phone:** (915) 893-4288
- **Mailing address:** 2225 E RANDOL MILL RD, STE 630, ARLINGTON, TX 76011-6315
- **Mailing address phone:** (817) 607-7400

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | — | — | Yes |
| 332BN1400X | Nursing Facility Supplies (DME) | — | — | — |

## Other

- **Enumeration date:** 10/19/2009
- **Last updated:** 10/21/2009