Organization
WACO HEALTHCARE RESIDENCE LLC
Active
Other names
Crestview Nursing and Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOE NEUMAN (MANAGER)
(888) 396-3462
Entity
Organization
Contact information
Practice address
1400 LAKE SHORE DR, WACO, TX 76708-3718
(254) 753-0291
(254) 753-3343
Mailing address
111 CLIFTON AVE, LAKEWOOD, NJ 08701-3342
(888) 396-3462
(214) 396-3462
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004025
STATE FACILITY ID
TX
Enumeration date
06/11/2019
Last updated
06/11/2019
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