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NPI Code Detail

MEDICARE: STONEGATE NURSING CENTER LTD

MEDICARE: STONEGATE NURSING CENTER LTD
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
1314000000XSkilled Nursing Facility5387TX

General Provider Information

NPI Number : 1508885658
Entity Type Code : Organization
Provider Name (Legal Business Name) : STONEGATE NURSING CENTER LTD
Provider Business Mailing Address
First Line : 4201 STONEGATE BLVD
Second Line :
City : FT WORTH
State : TX
Zip : 76109-9503
Country : US
Telephone Number : 817-924-5440
Fax Number : 817-924-5447
Provider Business Practice Location Address
First Line : 4201 STONEGATE BLVD
Second Line :
City : FT WORTH
State : TX
Zip : 76109-9503
Country : US
Telephone Number : 817-924-5440
Fax Number : 817-924-5447
Authorized Official
Title or Position : PARTNER-EXECUTIVE DIRECTOR
Name : MS. ALTA SUE HAYES
Credential :
Telephone Number : 817-924-5440
Provider Enumeration Date : 07/19/2006
Last Update Date : 08/22/2020

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Directions to “STONEGATE NURSING CENTER LTD ” Practice Location

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