MEDICARE: ARLINGTON TX MANAGEMENT LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility	130704	TX

General Provider Information

NPI Number	:	1386999480
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARLINGTON TX MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	7150 PARSONS BLVD
Second Line	:	SUITE 1001
City	:	FLUSHING
State	:	NY
Zip	:	11365-4131
Country	:	US
Telephone Number	:	516-596-5222
Fax Number	:	877-311-5460

Provider Business Practice Location Address
First Line	:	405 DUNCAN PERRY RD
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5412
Country	:	US
Telephone Number	:	817-649-3366
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MRS. MICHAL GOLDMAN
Credential	:
Telephone Number	:	516-596-5222

Provider Enumeration Date	:	07/16/2012
Last Update Date	:	07/19/2012

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