Basic Information
Provider Information
NPI: 1508855016
EntityType: 2
ReplacementNPI:  
OrganizationName: SENIOR MANAGEMENT SERVICES OF PALESTINE INC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: GREENBRIER NURSING & REHABILITATION CENTER
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 W ARBROOK BLVD
Address2: SUITE 210
City: ARLINGTON
State: TX
PostalCode: 760154327
CountryCode: US
TelephoneNumber: 8174681991
FaxNumber: 8174683133
Practice Location
Address1: 2404 HWY 155
Address2:  
City: PALESTINE
State: TX
PostalCode: 75803
CountryCode: US
TelephoneNumber: 9037296024
FaxNumber: 9037296942
Other Information
ProviderEnumerationDate: 10/18/2005
LastUpdateDate: 08/22/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: CLANTON
AuthorizedOfficialFirstName: TROY
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8174681991
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
314000000X108320TXY Nursing & Custodial Care FacilitiesSkilled Nursing Facility 

No ID Information.


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