Provider Demographics
NPI:1407993991
Name:LIVING CENTERS OF TEXAS INC
Entity Type:Organization
Organization Name:LIVING CENTERS OF TEXAS INC
Other - Org Name:STONEYBROOK HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:EHRLICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-929-4762
Mailing Address - Street 1:2808 STONEYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-4611
Mailing Address - Country:US
Mailing Address - Phone:713-782-4355
Mailing Address - Fax:713-782-5429
Practice Address - Street 1:2808 STONEYBROOK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-4611
Practice Address - Country:US
Practice Address - Phone:713-782-4355
Practice Address - Fax:713-782-5429
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
675078Medicare ID - Type Unspecified