Organization
MANSFIELD LONG TERM CARE LLC
Active
Other names
The Pavilion at Creekwood
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE MEYER (PRESIDENT)
(817) 779-6500
Entity
Organization
Contact information
Practice address
2100 CANNON DRIVE, MANSFIELD, TX 76063
(817) 779-6500
(817) 779-6501
Mailing address
920 RIDGEBROOK RD, SPARKS, MD 21152-9390
(817) 779-6500
(817) 779-6501
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001026926
—
TX
Enumeration date
02/13/2015
Last updated
10/17/2019
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