Organization
BROADMOOR CONTINUING CARE CENTER LTD. CO.
Active
Other names
The Broadmoor at Creekside Park
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M SMITH (LEGAL ASSISTANT/CLAIMS MANAGER)
(214) 954-4114
Entity
Organization
Contact information
Practice address
5665 CREEKSIDE FOREST DR, THE WOODLANDS, TX 77389-4969
(281) 255-8180
(281) 255-8190
Mailing address
2537 GOLDEN BEAR DR, CARROLLTON, TX 75006-2377
(214) 954-4114
(214) 880-0053
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001025592
—
TX
Enumeration date
11/20/2013
Last updated
04/30/2015
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