Organization
BRENTWOOD HEALTHCARE, LTD
Active
Other names
BRENTWOOD PLACE ONE
Organization subpart
No
Provider details
NPI number
Authorized official
DICK STEBBINS CPA (PRESIDENT OF GENERAL PARTNER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
3505 S BUCKNER BLVD BLDG 2, DALLAS, TX 75227-5451
(214) 388-0609
(214) 388-2643
Mailing address
600 E WHALEY ST, LONGVIEW, TX 75601-6525
(903) 757-5360
(903) 236-7036
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
110323
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000512607
—
TX
05
—
022675501
—
TX
05
—
112772202
—
TX
05
—
HO6756803
—
TX
Enumeration date
10/21/2005
Last updated
04/09/2014
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