BROADMORE SNF OPERATIONS, LLC
Nursing at New Copeland Rd, Tyler, TX

License number
Texas 124617
Category
Nursing
Type
Skilled Nursing Facility
Owner
Name: JOHN PAUL TAYLOR
Title: AUTHORIZED OFFICIAL
Phone: (972) 899-4401
Address
Address 2
5505 New Copeland Rd, Tyler, TX 75703
1500 Waters Ridge Dr STE 200, Lewisville, TX 75057
National Provider ID: 1770752172
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

See more information about BROADMORE SNF OPERATIONS, LLC at bizstanding.com

BROADMORE SNF OPERATIONS, LLC

Austin, TX  -  Lewisville, TX

Doing business as:
Broadmore Snf Operations, LLC<br>Providence Park of Tyler<br>Providence Park Rehabilitation and Skilled Nursing
Registration:
Sep 12, 2007
Addresses:
800 Brazos St STE 400, Austin, TX 78701 (Mailing)
1500 Waters Rdg Dr, Lewisville, TX 75057
State ID:
0800870169
Business type:
Domestic Limited Liability Company (LLC)
Members:
Brandon R Parker Sci Cons (MEMBER), 5467 New Copeland Rd, Tyler, TX 75703,Brooke D Parker Sci Const (MEMBER, Member), 5467 New Copeland Rd, Tyler, TX 75703,Jim Kisher (MEMBER, Member), 1500 Waters Rdg Dr, Lewisville, TX 75057,...
Agent:
Capitol Corporate Services, Inc,800 Brazos SUITE 400, Austin, TX 78701 (Physical)
TIN:
32033729420

Broadmore Snf Operations, LLC

5505 New Copeland Rd, Tyler, TX 75703

Industry:
Whol Drugs/Sundries
Office Managers:
Paula Pierce (Authorized Officer, Officer),Sherry Wyatt Office Manager, inactive

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