Center for Long Term Care of Woodridge, Inc

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

CENTER FOR LONG TERM CARE OF WOODRIDGE, INC

Practice address

1500 Autumn Dr
Grapevine, TX 76051-3103

Phone

(817) 488-8585

Fax

(817) 488-7298

NPI assigned

Mar 14, 2006

Last updated

Aug 22, 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

Gary R Trebert

Title

Ceo

Phone

(817) 359-2000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1142294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1457329658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 155635",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761550635",
            "telephone_number": "817-359-2000",
            "fax_number": "817-359-2093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 AUTUMN DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760513103",
            "telephone_number": "817-488-8585",
            "fax_number": "817-488-7298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR LONG TERM CARE OF WOODRIDGE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TREBERT",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "817-359-2000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Caton, OD
• Gianna Cavataio, CCC-SLP
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• Cedarbloom, LLC (ComForCare Home Care-Grapevine)
• Center for Vein Restoration TX2 LLC
• Centerpointe Behavioral Health Dallas LLC
• Centrum Medical Group, PLLC
• Jeffrey Joseph Cervenka
• Justin Chan, M. D.

• Skilled Nursing Facility in Grapevine, TX
• Providers in Grapevine, 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 Aug 22, 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.