Basic Information
| Provider Information | |||||||||
| NPI: | 1295768927 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SOUTH LIMESTONE HOSPITAL DISTRICT | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | SETTLERS RIDGE CARE CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 WATERS RIDGE DR | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LEWISVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750576011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9728994401 | ||||||||
| FaxNumber: | 9728994460 | ||||||||
| Practice Location | |||||||||
| Address1: | 1280 SETTLERS RDG | ||||||||
| Address2: | |||||||||
| City: | CELINA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750092282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9723828600 | ||||||||
| FaxNumber: | 9723828606 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 01/12/2015 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | PRICE | ||||||||
| AuthorizedOfficialFirstName: | LARRY | ||||||||
| AuthorizedOfficialMiddleName: | N | ||||||||
| AuthorizedOfficialTitleorPosition: | AUTHORIZED OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 2547292689 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 314000000X | 117822 | TX | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
ID Information
| ID | Type | State | Issuer | Description | 186104901 | 01 | TX | MCD CO B TPI | OTHER | 001025408 | 05 | TX | MEDICAID |