SLP Fort Worth LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

SLP FORT WORTH LLC

Doing business as

Wellington Oaks Nursing & Rehabilitation

Practice address

701 Saint Louis Ave
Fort Worth, TX 76104-3324

Phone

(817) 332-9962

Fax

(817) 332-9252

NPI assigned

Dec 29, 2020

Last updated

Dec 29, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Cassandra Mistretta

Title

Ceo

Phone

(817) 410-7300

Specialties & licenses 1

Addresses

Other names 1

• Wellington Oaks Nursing & Rehabilitation Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1609200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609200000000",
    "number": "1023605730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 SAINT LOUIS AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043324",
            "telephone_number": "817-332-9962",
            "fax_number": "817-332-9252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 SAINT LOUIS AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043324",
            "telephone_number": "817-332-9962",
            "fax_number": "817-332-9252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLP FORT WORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-29",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A",
        "authorized_official_last_name": "MISTRETTA",
        "authorized_official_first_name": "CASSANDRA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-410-7300"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellington Oaks Nursing & Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Skilled Nursing Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.