Provider Demographics
NPI:1093773178
Name:FORT AUSTIN LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:FORT AUSTIN LIMITED PARTNERSHIP
Other - Org Name:BROOKDALE BROADWAY CITYVIEW
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP/CAO
Authorized Official - Prefix:
Authorized Official - First Name:BRYAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-221-2250
Mailing Address - Street 1:5301 BRYANT IRVIN RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4030
Mailing Address - Country:US
Mailing Address - Phone:817-294-2280
Mailing Address - Fax:
Practice Address - Street 1:5301 BRYANT IRVIN RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4030
Practice Address - Country:US
Practice Address - Phone:817-294-2280
Practice Address - Fax:817-294-3222
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BROOKDALE SENIOR LIVING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-01
Last Update Date:2014-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113161314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX455810Medicare Oscar/Certification