Provider Demographics
NPI:1003867201
Name:GRCC HOLDINGS LTD
Entity Type:Organization
Organization Name:GRCC HOLDINGS LTD
Other - Org Name:SILVER TREE NURSING AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:LIMITED PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAKE
Authorized Official - Middle Name:
Authorized Official - Last Name:HALLSTED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-566-9100
Mailing Address - Street 1:930 ROY RICHARD DR
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-1050
Mailing Address - Country:US
Mailing Address - Phone:210-566-9100
Mailing Address - Fax:210-566-9102
Practice Address - Street 1:930 ROY RICHARD DR
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-1050
Practice Address - Country:US
Practice Address - Phone:210-566-9100
Practice Address - Fax:210-566-9102
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX102647314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159330301OtherMEDICAID TPI
TX001014283Medicaid
TX001014283Medicaid