# IGNITE MEDICAL RESORT FORT WORTH, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659031268
- **Authorized official:** TIMOTHY FIELDS (CHIEF EXECUTIVE OFFICER)
- **Authorized official phone:** (630) 327-2951

## Contact information

- **Practice address:** 6301 OAKMONT BLVD, FORT WORTH, TX 76132-2814
- **Practice address phone:** (682) 312-8577
- **Mailing address:** 1550 N NORTHWEST HWY STE 430, PARK RIDGE, IL 60068-1461

## Taxonomy

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

## Other

- **Enumeration date:** 12/22/2021
- **Last updated:** 02/24/2026