# WATERMARK BROADWAY CITYVIEW, LLC

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

## Provider details

- **NPI number:** 1740899855
- **Authorized official:** DAVID FRESHWATER (DIRECTOR)
- **Authorized official phone:** (520) 797-4000

## Contact information

- **Practice address:** 5301 BRYANT IRVIN RD, FORT WORTH, TX 76132-4030
- **Practice address phone:** (817) 346-9407
- **Mailing address:** 2020 W RUDASILL RD, TUCSON, AZ 85704-7800

## Taxonomy

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

## Other

- **Enumeration date:** 07/24/2020
- **Last updated:** 01/19/2023