Provider Demographics
NPI:1023018884
Name:SENIOR HEALTH NORTHWOOD LLC
Entity Type:Organization
Organization Name:SENIOR HEALTH NORTHWOOD LLC
Other - Org Name:NORTHWOOD HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REGIONAL CASE MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:SNOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:940-464-7016
Mailing Address - Street 1:1109 NORTHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-0000
Mailing Address - Country:US
Mailing Address - Phone:830-693-3551
Mailing Address - Fax:830-693-7266
Practice Address - Street 1:1109 NORTHWOOD DR
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-0000
Practice Address - Country:US
Practice Address - Phone:830-693-3551
Practice Address - Fax:830-693-7266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-22
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112335314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility