Provider Demographics
NPI:1467944108
Name:SUMMIT LTC CENTER LLC
Entity Type:Organization
Organization Name:SUMMIT LTC CENTER LLC
Other - Org Name:HOLIDAY NURSING & REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:M
Authorized Official - Last Name:SLIMMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-681-4811
Mailing Address - Street 1:6050 SOUTHWEST BLVD, SUITE 150
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76109
Mailing Address - Country:US
Mailing Address - Phone:817-681-4811
Mailing Address - Fax:
Practice Address - Street 1:280 MOFFITT DR
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-8520
Practice Address - Country:US
Practice Address - Phone:936-598-3371
Practice Address - Fax:936-598-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility