Organization
DIVERSICARE DOCTORS LLC
Active
Parent organization
DIVERSICARE TEXAS I, LLC
Other names
Diversicare of Lake Highlands
Organization subpart
Yes
Provider details
NPI number
Legal business name
DIVERSICARE TEXAS I, LLC
Authorized official
MATTHEW J. WEISHAAR (CHIEF FINANCIAL OFFICER)
(615) 550-9459
Entity
Organization
Contact information
Practice address
9009 WHITE ROCK TRL, DALLAS, TX 75238-3347
(214) 355-3300
(615) 620-7875
Mailing address
1621 GALLERIA BLVD, BRENTWOOD, TN 37027-2926
(214) 771-7575
(615) 915-6935
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
130500
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001015188
—
TX
Enumeration date
07/19/2007
Last updated
04/07/2023
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