Healthcare Provider Details

I. General information

NPI: 1174767701
Provider Name (Legal Business Name): PLAINVIEW HEALTHCARE CENTER LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2009
Last Update Date: 04/27/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 W 24TH ST
PLAINVIEW TX
79072-1808
US

IV. Provider business mailing address

930 RIDGEBROOK RD
SPARKS MD
21152-9390
US

V. Phone/Fax

Practice location:
  • Phone: 806-296-5584
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: AMANDA STEWART
Title or Position: PRESIDENT
Credential:
Phone: 806-296-5584