Organization · Type 2 NPI

Diversicare Doctors LLC

Skilled Nursing Facility · Dallas, TX

NPI number 1962602805 Active

Practice location

9009 White Rock Trl
Dallas, TX 75238-3347

Call (214) 355-3300 Map

Fax (615) 620-7875

Mailing address

1621 Galleria Blvd
Brentwood, TN 37027-2926

Specialties and licenses

Taxonomy	Code	License
Skilled Nursing Facility Primary	314000000X	130500 (TX)

Skilled Nursing Facility: (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to r…

15 other providers at this address

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NPI record

NPI: 1962602805
Entity type: Organization (Type 2)
Issued: Jul 19, 2007
Last updated: Apr 7, 2023
Status: Active
Subpart: Yes of Diversicare Texas I, LLC

Other names

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Diversicare of Lake Highlands · doing business as
Diversicare of Lake Highlands · doing business as

Authorized official

Matthew J. Weishaar
Chief Financial Officer
(615) 550-9459

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This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1962602805

Diversicare Doctors LLC's National Provider Identifier is 1962602805, issued on Jul 19, 2007. The primary taxonomy on file is Skilled Nursing Facility (314000000X), and the practice location is in Dallas, TX. The record was last updated on Apr 7, 2023.