Organization
1350 E. LOOKOUT DRIVE OPERATIONS LLC
Active
Parent organization
GENESIS TX HOLDINGS LLC
Other names
PowerBack Rehabilitation Richardson
Organization subpart
Yes
Provider details
NPI number
Legal business name
GENESIS TX HOLDINGS LLC
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
1350 E LOOKOUT DR, RICHARDSON, TX 75082-4106
(972) 220-2000
Mailing address
1350 E LOOKOUT DR, RICHARDSON, TX 75082-4106
(972) 220-2000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
145038
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026954
—
TX
Enumeration date
03/27/2015
Last updated
10/24/2017
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