# SOUTHWEST LTC - TEMPLE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Temple Manor Nursing Home
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639560337
- **Authorized official:** RONALD PAYNE (MANAGER)
- **Authorized official phone:** (469) 916-6100

## Contact information

- **Practice address:** 100 WEST GREEN AVE, TEMPLE, OK 73568
- **Practice address phone:** (580) 342-6228
- **Mailing address:** 5560 TENNYSON PKWY STE 210, PLANO, TX 75024-3582
- **Mailing address phone:** (469) 916-6100
- **Mailing address fax:** (469) 916-6105

## Taxonomy

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

## Other

- **Enumeration date:** 02/17/2015
- **Last updated:** 08/03/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 200645870A | — | OK |
| 05 | — | NH1702 | — | OK |