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Organization

HOLLAND LAKE SCC LLC

Active
Other names
Holland Lake Nursing & Rehab
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL TEMPLETON (CHIEF OPERATIONS OFFICER)
(214) 252-7600
Entity
Organization

Contact information

Practice address
1201 HOLLAND LAKE DR, WEATHERFORD, TX 76086-5851
(817) 598-0160
Mailing address
14841 DALLAS PKWY, DALLAS, TX 75254-7685
(214) 252-7600

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001027377
TX
Enumeration date
10/21/2015
Last updated
03/16/2022
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