Manor Care of Fort Worth TX (NW) LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

111031 Issued in TX

Legal business name

MANOR CARE OF FORT WORTH TX (NW) LLC

Practice address

2129 Skyline Dr
Fort Worth, TX 76114-1924

Phone

(817) 626-1956

Fax

(817) 625-2515

NPI assigned

Jun 13, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Martin D Allen

Title

Director

Phone

(419) 252-5734

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Heartland Health Care Center-Ft. Worth Doing business as

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

{
    "created_epoch": "1150156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1496102400000",
    "number": "1912940701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SUMMIT ST",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436042615",
            "telephone_number": "419-252-5500",
            "fax_number": "877-385-9446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 SKYLINE DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761141924",
            "telephone_number": "817-626-1956",
            "fax_number": "817-625-2515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANOR CARE OF FORT WORTH TX (NW) LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-13",
        "last_updated": "2017-05-30",
        "status": "A",
        "authorized_official_last_name": "ALLEN",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "419-252-5734",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": "111031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001015378",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Heartland Health Care Center-Ft. Worth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kristal Manning, LPC
• Madeline Manning, D.O.
• Julianne Mannix
• Lauren Elizabeth Manolescu
• Roseline Osebe Manono
• Sandy Manoushagian, APRN, FNP
• Shaterra Manoy, MSN, APRN, PMHNP-BC
• Blanca Ivette Manriquez, COTA/L
• Samantha Manriquez
• Cynthia Mansah-Poku

• 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 May 30, 2017; 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.