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Organization
AZLE MANOR HEALTH CARE, L.L.L.P.
Active
Organization
AZLE MANOR HEALTH CARE, L.L.L.P.
Active
Other names
Azle Manor Health Care and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MAURA PANOS (ACCOUNTANT)
(817) 444-2516
Entity
Organization
Contact information
Practice address
721 DUNAWAY LN, AZLE, TX 76020
(817) 444-2536
Mailing address
7150 GANTT ACCESS RD, AZLE, TX 76020-5638
(817) 444-2516
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000119994
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000498401
—
TX
05
—
001025390
—
TX
Enumeration date
06/14/2005
Last updated
08/03/2020
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