Organization
SENIOR CARE SERVICES
Active
Other names
The Vintage Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
SHANE LEWIS (VP CFO)
(972) 303-9000
Entity
Organization
Contact information
Practice address
205 N BONNIE BRAE ST, DENTON, TX 76201-3766
(972) 303-9000
(972) 303-9992
Mailing address
1413 EAST I 30, STE 7, GARLAND, TX 75043-4598
(972) 303-9000
(972) 303-9992
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
004939
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH2663
BCBS
TX
Enumeration date
06/02/2005
Last updated
11/13/2007
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