# CENTERS FOR LONG TERM CARE ANCILLARY SERVICES INC.

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

## Provider details

- **NPI number:** 1700892593
- **Authorized official:** MR. GARY R TREBERT (OWNER)
- **Authorized official phone:** (214) 634-0868

## Contact information

- **Practice address:** 7606 PEBBLE DR, BLDG 28, FORT WORTH, TX 76118-6994
- **Practice address phone:** (214) 624-0868
- **Practice address fax:** (817) 595-8929
- **Mailing address:** 7606 PEBBLE DR, BLDG 28, FORT WORTH, TX 76118-6994
- **Mailing address phone:** (214) 624-0868
- **Mailing address fax:** (817) 358-1080

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 0052443 | TX | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 08/22/2020