Organization
LIVINGSTON HEALTH CARE CENTER LTD. CO.
Active
Other names
The Bradford at Brookside
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ROBIN UNDERHILL (CHIEF EXECUTIVE)
(214) 954-4114
Entity
Organization
Contact information
Practice address
301 WEST PARK DRIVE, LIVINGSTON, TX 77351-8151
(936) 327-4341
(936) 327-6277
Mailing address
2537 GOLDEN BEAR DR, DALLAS, TX 75006-2377
(214) 954-4114
(214) 871-3057
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
114558
TX
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000465804
—
TX
05
—
022634201
—
TX
05
—
155314101
—
TX
01
—
HH068S
BLUE CROSS
TX
Enumeration date
09/22/2005
Last updated
12/19/2008
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