Provider Demographics
NPI:1275652604
Name:CASCADE-TARRANT HEALTH SERVICES, LTD
Entity Type:Organization
Organization Name:CASCADE-TARRANT HEALTH SERVICES, LTD
Other - Org Name:MATLOCK PLACE HEALTH AND REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:M
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-634-6633
Mailing Address - Street 1:7100 MATLOCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76002-3346
Mailing Address - Country:US
Mailing Address - Phone:936-634-6633
Mailing Address - Fax:936-634-6613
Practice Address - Street 1:7100 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76002-3346
Practice Address - Country:US
Practice Address - Phone:936-634-6633
Practice Address - Fax:936-634-6613
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX187899301OtherTPI NUMBER
TX001014955Medicaid
TX187899301OtherTPI NUMBER