Organization
SENIOR LIVING PROPERTIES LLC
Active
Other names
Van Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MARTIN (CFO)
(817) 410-7300
Entity
Organization
Contact information
Practice address
169 S OAK ST, VAN, TX 75790-3529
(903) 963-8641
(903) 963-5413
Mailing address
PO BOX 1389, GRAPEVINE, TX 76099-1389
(817) 410-7300
(817) 410-4711
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
123157
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000467107
—
TX
01
—
004671
FACILITY ID NO.
TX
Enumeration date
05/20/2006
Last updated
03/18/2010
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