Mansfield SNF LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MANSFIELD SNF LLC

Doing business as

Isle at Watercrest - Mansfield, LLC

Practice address

200 E. Debbie Lane
Mansfield, TX 76063

Phone

(817) 453-3900

Fax

(817) 453-3909

NPI assigned

Nov 8, 2010

Last updated

Feb 16, 2011By 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

Mr. Craig Willard Spaulding, CPA

Title

Manager

Phone

(214) 370-2600

Specialties & licenses 1

Addresses

Other names 1

• Isle at Watercrest - Mansfield, LLC Doing business as

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

CLIA laboratory certificates

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

{
    "created_epoch": "1289174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1922309962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5307 E MOCKINGBIRD LN",
            "address_2": "SUITE 1010",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752065109",
            "telephone_number": "214-370-2600",
            "fax_number": "214-370-2699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E. DEBBIE LANE",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "76063",
            "telephone_number": "817-453-3900",
            "fax_number": "817-453-3909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANSFIELD SNF LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-08",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "SPAULDING",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "WILLARD",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "214-370-2600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CPA"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Isle at Watercrest - Mansfield, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Mansfield Walnut Creek Medical (First Choice Emergency Room)
• Soleima Dallana Mantilla, NP

• Skilled Nursing Facility in Mansfield, TX
• Providers in Mansfield, 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 Feb 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.