Healthcare Provider Details

I. General information

NPI: 1053031815
Provider Name (Legal Business Name): SWEENY NURSING & REHABILITATION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2022
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 N MCKINNEY ST
SWEENY TX
77480-3400
US

IV. Provider business mailing address

7358 N LINCOLN AVE
LINCOLNWOOD IL
60712-1710
US

V. Phone/Fax

Practice location:
  • Phone: 979-548-3383
  • Fax:
Mailing address:
  • Phone: 602-882-1273
  • 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: ARCHIE SHKOP
Title or Position: MANAGER
Credential:
Phone: 847-450-1425