Healthcare Provider Details

I. General information

NPI: 1336427129
Provider Name (Legal Business Name): GREEN OAKS SCC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2011
Last Update Date: 03/16/2022
Certification Date: 03/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 W GREEN OAKS BLVD
ARLINGTON TX
76016-2261
US

IV. Provider business mailing address

14841 DALLAS PKWY
DALLAS TX
75254-7685
US

V. Phone/Fax

Practice location:
  • Phone: 817-222-6000
  • Fax: 817-417-1737
Mailing address:
  • Phone: 214-252-7600
  • Fax: 214-252-7704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL TEMPLETON
Title or Position: CHIEF OPERATIONS OFFICER
Credential:
Phone: 214-252-7600