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Organization
ELITE RESIDENTIAL FOR MATURED ADULTS
Active
Organization
ELITE RESIDENTIAL FOR MATURED ADULTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VIKKILYNN PREVOST R.D.H (CO-OWNER/DIRECTOR)
(972) 347-6035
Entity
Organization
Contact information
Practice address
160 WILSON DR, PROSPER, TX 75078-8580
(972) 347-6035
(972) 347-6250
Mailing address
160 WILSON DR, PROSPER, TX 75078-8580
(972) 347-6035
(972) 347-6250
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/08/2008
Last updated
10/08/2008
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