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General NPI Number Information
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NPI Number | 1083673818
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Entity Type | Organization
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Legal Business Name | BRIARCLIFF HEALTH CENTER OF GREENVILLE, INC.
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4400 WALNUT ST
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City | GREENVILLE
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State | TX
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Zip | 75401-5586
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Country | US
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Telephone | 903-455-8729
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Fax | 903-455-5469
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Provider Business Mailing Address
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Address Line | 4400 WALNUT ST
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City | GREENVILLE
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State | TX
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Zip | 75401-5586
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Country | US
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Telephone | 903-455-8729
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Fax | 903-455-5469
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MR. JAMES L ROBERTS
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Credential |
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Telephone | 903-455-8729
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 115626
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License Number State | TX
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