Provider Demographics
NPI:1821233586
Name:RW SCC LLC
Entity Type:Organization
Organization Name:RW SCC LLC
Other - Org Name:ROCKWALL NURSING CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-436-4343
Mailing Address - Street 1:206 STORRS ST
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75087-4006
Mailing Address - Country:US
Mailing Address - Phone:972-771-5000
Mailing Address - Fax:972-771-1504
Practice Address - Street 1:206 STORRS ST
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75087-4006
Practice Address - Country:US
Practice Address - Phone:972-771-5000
Practice Address - Fax:972-771-1504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001016945Medicaid
TX675402Medicare Oscar/Certification
TX675402Medicare Oscar/Certification