MEDICARE: DENTON TRANSITIONAL LTCH, LP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	284300000X	Special Hospital

General Provider Information

NPI Number	:	1033204342
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTON TRANSITIONAL LTCH, LP

Provider Business Mailing Address
First Line	:	2813 S. MAYHILL RD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-5910
Country	:	US
Telephone Number	:	940-320-2300
Fax Number	:	940-320-2301

Provider Business Practice Location Address
First Line	:	2813 S MAYHILL RD
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76208-5910
Country	:	US
Telephone Number	:	940-320-2300
Fax Number	:	940-565-8610

Authorized Official
Title or Position	:	CHIEF EXECUTIVE OFFICER
Name	:	MR. ROBERT F BERRY
Credential	:
Telephone Number	:	512-626-2751

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	01/24/2008

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