Organization
AZLE MANOR HEALTH CARE, L.L.L.P.
Active
Other names
Azle Manor Health Care and Rehabilitation
Organization subpart
No
Provider details
NPI number
Authorized official
MAURA PANOS (ACCOUNTANT)
(817) 444-2516
Entity
Organization
Contact information
Practice address
721 DUNAWAY LN, AZLE, TX 76020
(817) 444-2536
Mailing address
7150 GANTT ACCESS RD, AZLE, TX 76020-5638
(817) 444-2516
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
000119994
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000498401
—
TX
05
—
001025390
—
TX
Enumeration date
06/14/2005
Last updated
08/03/2020
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