Provider Demographics
NPI:1093001984
Name:SPRING BRANCH SNF LLC
Entity Type:Organization
Organization Name:SPRING BRANCH SNF LLC
Other - Org Name:SPRING BRANCH TRANSITIONAL CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOM
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:SILBER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-382-1313
Mailing Address - Street 1:3119 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4234
Mailing Address - Country:US
Mailing Address - Phone:718-382-1313
Mailing Address - Fax:
Practice Address - Street 1:1615 HILLENDAHL BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-3413
Practice Address - Country:US
Practice Address - Phone:713-365-0561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675764Medicare Oscar/Certification