Provider Demographics
NPI:1104069830
Name:MEADOWCREST SPECIALTY HOSPITAL, LLC
Entity type:Organization
Organization Name:MEADOWCREST SPECIALTY HOSPITAL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:CHANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:SHELTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-464-7018
Mailing Address - Street 1:415 HIGHWAY 377 S
Mailing Address - Street 2:STE 200
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-5140
Mailing Address - Country:US
Mailing Address - Phone:940-464-7018
Mailing Address - Fax:940-464-7011
Practice Address - Street 1:535 COMMERCE ST
Practice Address - Street 2:SUITE B
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70056-7316
Practice Address - Country:US
Practice Address - Phone:940-464-7018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282E00000XHospitalsLong Term Care Hospital