Provider Demographics
NPI:1043608094
Name:LWT MANAGEMENT
Entity Type:Organization
Organization Name:LWT MANAGEMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:TENNERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-717-9548
Mailing Address - Street 1:4401 LITTLE RD
Mailing Address - Street 2:STE 550
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-5624
Mailing Address - Country:US
Mailing Address - Phone:817-717-9548
Mailing Address - Fax:817-717-9548
Practice Address - Street 1:4401 LITTLE RD
Practice Address - Street 2:STE 550
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-5624
Practice Address - Country:US
Practice Address - Phone:817-717-9548
Practice Address - Fax:817-717-9548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home