Healthcare Provider Details

I. General information

NPI: 1609132794
Provider Name (Legal Business Name): CAMP WOOD SNF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2012
Last Update Date: 05/10/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

710 HWY 55
CAMP WOOD TX
78833
US

IV. Provider business mailing address

PO BOX 830
CAMP WOOD TX
78833-0830
US

V. Phone/Fax

Practice location:
  • Phone: 830-597-5445
  • Fax: 877-334-9483
Mailing address:
  • Phone: 830-597-5445
  • Fax: 877-334-9483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. STEVEN D ROBINSON
Title or Position: MANAGING MEMBER
Credential:
Phone: 512-851-2273