Provider Demographics
NPI:1992170872
Name:CENTER NURSING & REHAB LLC
Entity type:Organization
Organization Name:CENTER NURSING & REHAB LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:SOLOMON
Authorized Official - Middle Name:
Authorized Official - Last Name:GURWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-346-4052
Mailing Address - Street 1:280 MOFFITT DR
Mailing Address - Street 2:
Mailing Address - City:CENTER
Mailing Address - State:TX
Mailing Address - Zip Code:75935-8520
Mailing Address - Country:US
Mailing Address - Phone:936-598-3371
Mailing Address - Fax:936-598-5726
Practice Address - Street 1:280 MOFFITT DR
Practice Address - Street 2:
Practice Address - City:CENTER
Practice Address - State:TX
Practice Address - Zip Code:75935-8520
Practice Address - Country:US
Practice Address - Phone:936-598-3371
Practice Address - Fax:936-598-5726
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-03
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001027366Medicaid
TX001027366Medicaid