Healthcare Provider Details

I. General information

NPI: 1942308861
Provider Name (Legal Business Name): J-S MANSFIELD OPERATIONS, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 12/18/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 N MILLER RD
MANSFIELD TX
76063
US

IV. Provider business mailing address

1500 WATERS RIDGE DR STE. 200
LEWISVILLE TX
75057-6011
US

V. Phone/Fax

Practice location:
  • Phone: 817-276-4800
  • Fax: 817-276-4850
Mailing address:
  • Phone: 972-899-4401
  • Fax: 972-899-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number120626
License Number StateTX

VIII. Authorized Official

Name: PAULA PIERCE
Title or Position: AUTHORIZED OFFICER
Credential:
Phone: 972-899-4401