# LONG TERM CARE OF TEXAS, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** LAKE VILLAGE NURSING & REHAB
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922088970
- **Authorized official:** MICHELLE ROBERTS RN (CORPORATE OFFICER)
- **Authorized official phone:** (972) 436-7571

## Contact information

- **Practice address:** 169 LAKE PARK RD, LEWISVILLE, TX 75057-2303
- **Practice address phone:** (972) 436-7571
- **Practice address fax:** (972) 221-4187
- **Mailing address:** 169 LAKE PARK RD, LEWISVILLE, TX 75057-2303
- **Mailing address phone:** (972) 436-7571
- **Mailing address fax:** (972) 221-4187

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 113275 | TX | Yes |

## Other

- **Enumeration date:** 01/17/2006
- **Last updated:** 08/22/2020