# BROADMOOR CONTINUING CARE CENTER LTD. CO.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Broadmoor at Creekside Park
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609206077
- **Authorized official:** LISA M SMITH (LEGAL ASSISTANT/CLAIMS MANAGER)
- **Authorized official phone:** (214) 954-4114

## Contact information

- **Practice address:** 5665 CREEKSIDE FOREST DR, THE WOODLANDS, TX 77389-4969
- **Practice address phone:** (281) 255-8180
- **Practice address fax:** (281) 255-8190
- **Mailing address:** 2537 GOLDEN BEAR DR, CARROLLTON, TX 75006-2377
- **Mailing address phone:** (214) 954-4114
- **Mailing address fax:** (214) 880-0053

## Taxonomy

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

## Other

- **Enumeration date:** 11/20/2013
- **Last updated:** 04/30/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 001025592 | — | TX |