Provider Demographics
NPI:1508754391
Name:413 MANSFIELD CARDINAL RD OPCO LLC
Entity type:Organization
Organization Name:413 MANSFIELD CARDINAL RD OPCO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NOCHUM
Authorized Official - Middle Name:
Authorized Official - Last Name:FREUND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-561-4495
Mailing Address - Street 1:413 MANSFIELD CARDINAL RD
Mailing Address - Street 2:
Mailing Address - City:KENNEDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76060-2805
Mailing Address - Country:US
Mailing Address - Phone:817-561-4495
Mailing Address - Fax:817-561-6033
Practice Address - Street 1:413 MANSFIELD CARDINAL RD
Practice Address - Street 2:
Practice Address - City:KENNEDALE
Practice Address - State:TX
Practice Address - Zip Code:76060-2805
Practice Address - Country:US
Practice Address - Phone:817-561-4495
Practice Address - Fax:817-561-6033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility