Healthcare Provider Details

I. General information

NPI: 1376833954
Provider Name (Legal Business Name): LOCKNEY MANAGEMENT, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/15/2011
Last Update Date: 06/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 N. MAIN STREET
LOCKNEY TX
79241-2059
US

IV. Provider business mailing address

71-50 PARSONS BLVD SUITE 1001
FLUSHING NY
11365-4131
US

V. Phone/Fax

Practice location:
  • Phone: 806-652-3375
  • Fax: 806-652-3466
Mailing address:
  • Phone: 516-596-5222
  • Fax: 877-311-5460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number130813
License Number StateTX

VIII. Authorized Official

Name: PHILIP FRIEDMAN
Title or Position: DIRECTOR
Credential:
Phone: 516-596-5222