Basic Information
| Provider Information | |||||||||
| NPI: | 1982930376 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CROWELL SNF LLC | ||||||||
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| OtherOrganizationName: | CROWELL NURSING CENTER | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2225 E RANDOL MILL RD | ||||||||
| Address2: | STE 630 | ||||||||
| City: | ARLINGTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 760116315 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8176077400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 200 SOUTH B AVENUE | ||||||||
| Address2: | |||||||||
| City: | CROWELL | ||||||||
| State: | TX | ||||||||
| PostalCode: | 79227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9406841511 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2009 | ||||||||
| LastUpdateDate: | 10/20/2009 | ||||||||
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| AuthorizedOfficialLastName: | KOHN | ||||||||
| AuthorizedOfficialFirstName: | ZEVI | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 9173709063 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BN1400X | N | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies | 314000000X | Y | Nursing & Custodial Care Facilities | Skilled Nursing Facility |
No ID Information.