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Organization
BRENTWOOD HEALTHCARE, LTD
Active
Organization
BRENTWOOD HEALTHCARE, LTD
Active
Other names
BRENTWOOD PLACE ONE
Organization subpart
No
Provider details
NPI number
Authorized official
DICK STEBBINS CPA (PRESIDENT OF GENERAL PARTNER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
3505 S BUCKNER BLVD BLDG 2, DALLAS, TX 75227-5451
(214) 388-0609
(214) 388-2643
Mailing address
600 E WHALEY ST, LONGVIEW, TX 75601-6525
(903) 757-5360
(903) 236-7036
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000512607
—
TX
05
—
022675501
—
TX
05
—
112772202
—
TX
05
—
HO6756803
—
TX
Enumeration date
10/21/2005
Last updated
04/09/2014
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