Organization Active NPI

SLP Willis LLC

  • Skilled Nursing Facility
  • Willis, TX
National Provider Identifier
1568070001
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
SLP WILLIS LLC
Practice address
3000 N Danville St
Willis, TX 77378-3490
Phone
(936) 856-4312
Fax
(936) 856-4364
NPI assigned
Jul 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Authorized official

Name
Richard Agnew
Title
Authorized Official
Phone
(512) 565-6159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

3000 N Danville St
Willis, TX 77378-3490

Mailing address

3000 N Danville St
Willis, TX 77378-3490
Phone (936) 856-4312

Other names 1

  • Willis Nursing and Rehabilitation Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210429001825 TX Part A Provider - Skilled Nursing Facility 8325467756 Practice locations: Willis, TX

Skilled nursing facility certification: CCN 675274

Legal name
SLP WILLIS LLC
Doing business as
WILLIS NURSING AND REHABILITATION
Certification status
Active
Provider type (POS)
Nursing home – SNF/NF distinct part
Participating since
Feb 2, 1994
Last certification
Jun 28, 2024
Beds
114
Ownership / control type
Limited Liability Corporation
Multi-facility organization
Senior Living Properties
Organization structure
LLCProprietary
Enrollment address
3000 N Danville St
Willis, TX 77378-3490
Nursing home name
WILLIS NURSING AND REHABILITATION
Affiliated entity
SLP OPERATIONS

Care Compare: Nursing home

Medicare Care Compare
Listed as
Willis Nursing and RehabilitationCCN 675274
Overall star rating
4 of 5
Health inspections
5 of 5
Staffing
1 of 5
Quality measures
4 of 5
Type
Medicare and Medicaid
Ownership
For profit - Limited Liability company
Certified
Feb 2, 1994
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
11449.5 residents per day on average
Chain
SLP Operations7 facilities in the chain
Penalties (3 years)
1Fines totaling $7,443

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D0722472SLP Willis, LLC3000 N Danville Rd, Willis, TX 77378Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

300 N Danville St
Willis, TX 77378
Phone (936) 856-4312

Ownership & related parties

All disclosed owners & managing parties 13

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Gary Whitworth Individual 5% Or Greater Indirect Ownership InterestMember Jun 1, 2023 33.77%
SLP Omega Operations, LLC Organization, Bedford, TX LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Jun 1, 2023 100%
Darren Boswell Individual 5% Or Greater Indirect Ownership InterestMember Jun 1, 2023 33.77%
Senior Living Properties LLC Organization, Bedford, TX LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Willis Texas Aviv LLC Organization, Hunt Valley, MD LLC, Real estate investment trust (REIT), Owned by another organization or individual 5% Or Greater Security Interest Aug 1, 2020 100%
Adp of the SNF Aug 1, 2020
SLP Operations, LLC Organization, Bedford, TX LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2023 100%
Milton Guerrero Individual Operational/Managerial Control Mar 25, 2013
Adp of the SNF Mar 25, 2013
Joshua Leonard Individual Corporate OfficerInterim Ceo Oct 1, 2024
Operational/Managerial Control Oct 1, 2024
Organization, Hunt Valley, MD Real estate investment trust (REIT) Adp of the SNF Aug 1, 2020
James E. Eden Individual 5% Or Greater Indirect Ownership InterestMember Jun 1, 2023 32.47%
Organization, Hunt Valley, MD Real estate investment trust (REIT) Adp of the SNF Aug 1, 2020
SLP Management Holdings, LLC Organization, Bedford, TX LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Jun 1, 2023 67.53%
Laronda Simmons Individual Adp of the SNF Feb 18, 2021

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1595289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751241600000",
    "number": "1568070001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 N DANVILLE ST",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773783490",
            "telephone_number": "936-856-4312",
            "fax_number": "936-856-4364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N DANVILLE ST",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773783490",
            "telephone_number": "936-856-4312",
            "fax_number": "936-856-4364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLP WILLIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-21",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A",
        "authorized_official_last_name": "AGNEW",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "512-565-6159"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Willis Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Willis Nursing and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Willis, TX

Sources for this page

Verify at the official NPI Registry.