MEDICARE: CENTERS FOR LONG TERM CARE OF RICHLAND HILLS, INC

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

General Provider Information

NPI Number	:	1922072743
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CENTERS FOR LONG TERM CARE OF RICHLAND HILLS, INC

Provider Business Mailing Address
First Line	:	PO BOX 155635
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76155-0635
Country	:	US
Telephone Number	:	817-359-2000
Fax Number	:	817-359-2093

Provider Business Practice Location Address
First Line	:	7146 BAKER BLVD
Second Line	:
City	:	RICHLAND HILLS
State	:	TX
Zip	:	76118-5801
Country	:	US
Telephone Number	:	817-589-1734
Fax Number	:	817-589-0647

Authorized Official
Title or Position	:	CEO
Name	:	GARY TREBERT
Credential	:
Telephone Number	:	817-359-2000

Provider Enumeration Date	:	02/16/2006
Last Update Date	:	08/22/2020

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