Healthcare Provider Details

I. General information

NPI: 1023045267
Provider Name (Legal Business Name): HOLIDAY NURSING CENTER-CENTER TX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 MOFFITT DR HIGHWAY 87N
CENTER TX
75935-8520
US

IV. Provider business mailing address

333 N SUMMIT ST ATTN BARRY LAZARUS
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 936-598-3371
  • Fax: 936-598-5726
Mailing address:
  • Phone: 419-252-5541
  • Fax: 419-252-5548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number106747
License Number StateTX

VIII. Authorized Official

Name: MR. BARRY A LAZARUS
Title or Position: VICE PRESIDENT - REIMBURSEMENTS
Credential:
Phone: 419-252-5541