Provider Demographics
NPI:1417598368
Name:CC SNF TX MANAGEMENT LLC
Entity type:Organization
Organization Name:CC SNF TX MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:
Authorized Official - Last Name:FRIEDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-299-3223
Mailing Address - Street 1:680 CENTRAL AVE UNIT 101
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2329
Mailing Address - Country:US
Mailing Address - Phone:212-322-9223
Mailing Address - Fax:
Practice Address - Street 1:3050 SUNNYBROOK RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78415-1748
Practice Address - Country:US
Practice Address - Phone:361-853-9981
Practice Address - Fax:361-853-1907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-02
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility