Organization
WEST LAKE HEALTHCARE RESIDENCE OPERATOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEF NEUMAN (MANAGER)
(214) 396-3462
Entity
Organization
Contact information
Practice address
825 W. KEARNEY, MESQUITE, TX 75149-3206
(972) 288-7688
Mailing address
111 CLIFTON AVE, LAKEWOOD, NJ 08701-3342
(214) 396-3462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001027232
—
TX
01
—
005142
DADS
TX
Enumeration date
08/19/2015
Last updated
03/30/2018
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