Provider Demographics
NPI:1558314310
Name:SENIOR LIVING PROPERTIES LLC
Entity Type:Organization
Organization Name:SENIOR LIVING PROPERTIES LLC
Other - Org Name:ANAHUAC HEALTHCARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-410-7300
Mailing Address - Street 1:PO BOX 1389
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76099-1389
Mailing Address - Country:US
Mailing Address - Phone:817-410-7300
Mailing Address - Fax:817-810-7411
Practice Address - Street 1:300 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:ANAHUAC
Practice Address - State:TX
Practice Address - Zip Code:77514
Practice Address - Country:US
Practice Address - Phone:409-267-3164
Practice Address - Fax:409-267-3764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2008-09-18
Deactivation Date:2006-05-25
Deactivation Code:
Reactivation Date:2006-11-08
Provider Licenses
StateLicense IDTaxonomies
TX125018314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX004901OtherFACILITY ID
TX000490106Medicaid
TX000490106Medicaid
TX1248470020Medicare NSC