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Organization
CEDAR PARK SNF LLC
Active
Organization
CEDAR PARK SNF LLC
Active
Other names
The Isle at Cedar Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG SPAULDING (MANAGER)
(214) 370-6200
Entity
Organization
Contact information
Practice address
2200 S. LAKELINE BLVD., CEDAR PARK, TX 78613-4563
(512) 219-0200
(512) 219-0466
Mailing address
5307 E MOCKINGBIRD LN, SUITE 1010, DALLAS, TX 75206-5109
(214) 370-2600
(214) 370-2699
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
133153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001019567
—
TX
Enumeration date
03/16/2011
Last updated
08/21/2012
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