Organization
BRENTWOOD HEALTHCARE, LTD
Active
Other names
BRENTWOOD PLACE TWO
Organization subpart
No
Provider details
NPI number
Authorized official
DICK STEBBINS CPA (PRES OF GENERAL PARTNER)
(903) 757-5360
Entity
Organization
Contact information
Practice address
3505 S BUCKNER BLVD BLDG 3, DALLAS, TX 75227-5451
(214) 388-0424
(214) 381-4454
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
110094
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000514806
—
TX
05
—
094685702
—
TX
05
—
112772201
—
TX
05
—
HO6757027
—
TX
Enumeration date
10/24/2005
Last updated
09/13/2012
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