Organization
IHS ACQUISITION NO 133 INC
Active
Other names
Grand Prairie Healthcare Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN REYNOLDS (CEO)
(410) 513-8738
Entity
Organization
Contact information
Practice address
820 SMALL ST, GRAND PRAIRIE, TX 75050-5856
(972) 262-1351
(972) 642-0567
Mailing address
820 SMALL ST, GRAND PRAIRIE, TX 75050-5856
(972) 262-1351
(972) 642-0567
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
134458
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000518805
—
TX
Enumeration date
07/20/2005
Last updated
07/16/2014
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