Provider Demographics
NPI:1689900151
Name:BENBROOK SNF LLC
Entity Type:Organization
Organization Name:BENBROOK SNF LLC
Other - Org Name:BENBROOK NURSING & REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ELIEZER
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-338-2999
Mailing Address - Street 1:2225 E RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76011-6315
Mailing Address - Country:US
Mailing Address - Phone:817-607-7400
Mailing Address - Fax:
Practice Address - Street 1:1000 MCKINLEY ST
Practice Address - Street 2:
Practice Address - City:BENBROOK
Practice Address - State:TX
Practice Address - Zip Code:76126-3474
Practice Address - Country:US
Practice Address - Phone:817-249-0200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No332BN1400XSuppliersDurable Medical Equipment & Medical SuppliesNursing Facility Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675906Medicare Oscar/Certification