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General NPI Number Information
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NPI Number | 1346292638
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Entity Type | Organization
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Legal Business Name | SLP REGENCY MANOR LLC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 3011 W ADAMS AVE
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City | TEMPLE
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State | TX
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Zip | 76504-2873
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Country | US
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Telephone | 254-733-1626
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Fax | 254-770-3074
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Provider Business Mailing Address
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Address Line | 3011 W ADAMS AVE
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City | TEMPLE
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State | TX
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Zip | 76504-2873
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Country | US
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Telephone | 254-773-1626
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | RICHARD AGNEW
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Credential |
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Telephone | 512-565-6159
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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 |
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License Number State | TX
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