Organization
THI OF TEXAS AT MIMOSA, LLC
Active
Other names
Mimosa Manor
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID KREUZER (PRESIDENT)
(817) 431-2518
Entity
Organization
Contact information
Practice address
459 KELLER PKWY, KELLER, TX 76248-2302
(817) 431-2518
(817) 379-0369
Mailing address
930 RIDGEBROOK RD, SPARKS, MD 21152-9390
(410) 773-1000
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
10/07/2006
Last updated
11/19/2007
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