# BRENTWOOD HEALTHCARE, LTD

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BRENTWOOD PLACE ONE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1700875705
- **Authorized official:** DICK STEBBINS CPA (PRESIDENT OF GENERAL PARTNER)
- **Authorized official phone:** (903) 757-5360

## Contact information

- **Practice address:** 3505 S BUCKNER BLVD BLDG 2, DALLAS, TX 75227-5451
- **Practice address phone:** (214) 388-0609
- **Practice address fax:** (214) 388-2643
- **Mailing address:** 600 E WHALEY ST, LONGVIEW, TX 75601-6525
- **Mailing address phone:** (903) 757-5360
- **Mailing address fax:** (903) 236-7036

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 110323 | TX | Yes |

## Other

- **Enumeration date:** 10/21/2005
- **Last updated:** 04/09/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 000512607 | — | TX |
| 05 | — | 022675501 | — | TX |
| 05 | — | 112772202 | — | TX |
| 05 | — | HO6756803 | — | TX |