Provider Demographics
NPI:1346419397
Name:SENIOR CARE RESOURCES, INC.
Entity Type:Organization
Organization Name:SENIOR CARE RESOURCES, INC.
Other - Org Name:SENIOR CARE HEALTH & REHABILITATION CENTER-DECATUR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT/CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:LEWIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-303-7500
Mailing Address - Street 1:1413 E INTERSTATE 30 STE 7
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-4598
Mailing Address - Country:US
Mailing Address - Phone:972-303-7500
Mailing Address - Fax:972-303-9700
Practice Address - Street 1:701 BENNETT RD
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3817
Practice Address - Country:US
Practice Address - Phone:940-626-2800
Practice Address - Fax:972-303-9992
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2015-01-09
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
TX001016444Medicaid
TX001016444Medicaid