Healthcare Provider Details

I. General information

NPI: 1558314310
Provider Name (Legal Business Name): SENIOR LIVING PROPERTIES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 09/18/2008
Certification Date:
Deactivation Date: 05/25/2006
Reactivation Date: 11/08/2006

III. Provider practice location address

300 HOSPITAL RD
ANAHUAC TX
77514
US

IV. Provider business mailing address

PO BOX 1389
GRAPEVINE TX
76099-1389
US

V. Phone/Fax

Practice location:
  • Phone: 409-267-3164
  • Fax: 409-267-3764
Mailing address:
  • Phone: 817-410-7300
  • Fax: 817-810-7411

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number125018
License Number StateTX

VIII. Authorized Official

Name: LARRY MARTIN
Title or Position: CFO
Credential:
Phone: 817-410-7300