Organization
FORT WORTH WEST SIDE LTD
Active
Other names
WEST SIDE CAMPUS OF CARE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DICK STEBBINS (MANAGER OF GENERAL PARTNER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
1950 S LAS VEGAS TRL, WHITE SETTLEMENT, TX 76108-3350
(817) 246-4995
Mailing address
600 E WHALEY ST, LONGVIEW, TX 75601-6525
(903) 757-5360
(903) 753-8621
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5204
—
TX
Enumeration date
11/16/2010
Last updated
01/03/2011
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