CCN: 675147 NPI: 1962423871 Organization

FIRESIDE LODGE RETIREMENT CENTER INC

4800 WHITE SETTLEMENT RD
FT WORTH, TX 761143955

Contact Information

Phone 8177386556
Fax 8177386559
Enumeration Date 2006-07-23
Last Updated 2020-08-22

Taxonomies

Code: 314000000X (Primary) License State: TX License: 117321

Inpatient Payment Attributes (IPSF) View Dictionary →

Effective Date:

censusDivision 7

cbsaActualGeographicLocation 23104

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9897283866

censusDivision 7

cbsaActualGeographicLocation 23104

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9897283866

censusDivision 7

cbsaActualGeographicLocation 23104

providerType 38

caseMixIndex 1.0

vbpAdjustment 0.9839448737

Outpatient Payment Attributes (OPSF) View Dictionary →

Effective Date:

cbsaActualGeographicLocation 23104

providerType 38

specialPaymentIndicator

carrierCode 04412

localityCode 28