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Organization

MRC CRESTVIEW

Active
Other names
Crestview Retirement Community
Organization subpart
No

Provider details

NPI number
Authorized official
DONALD M STEPHENS (CHIEF FINANCIAL OFFICER)
(281) 210-0138
Entity
Organization

Contact information

Practice address
2505 E. VILLA MARIA ROAD, BRYAN, TX 77802-2038
(979) 776-4778
(979) 774-7579
Mailing address
2505 E. VILLA MARIA ROAD, BRYAN, TX 77802-2038
(979) 776-4778
(979) 774-7579

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
114290
TX
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0010033963
TX
05
001003963
TX
05
004350
TX
Enumeration date
07/22/2005
Last updated
04/28/2020
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