Organization
CEDAR PARK SNF LLC
Active
Other names
The Isle at Cedar Ridge
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG SPAULDING (MANAGER)
(214) 370-6200
Entity
Organization
Contact information
Practice address
2200 S. LAKELINE BLVD., CEDAR PARK, TX 78613-4563
(512) 219-0200
(512) 219-0466
Mailing address
5307 E MOCKINGBIRD LN, SUITE 1010, DALLAS, TX 75206-5109
(214) 370-2600
(214) 370-2699
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
133153
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001019567
—
TX
Enumeration date
03/16/2011
Last updated
08/21/2012
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