Organization
LCS-MW LLC
Active
Other names
Monticello West
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE BRIDGEWATER (EXECUTIVE VP AND SECRETARY)
(515) 875-4768
Entity
Organization
Contact information
Practice address
5114 MCKINNEY AVE, DALLAS, TX 75205-3327
(214) 528-0660
Mailing address
400 LOCUST ST STE 820, DES MOINES, IA 50309-2334
(515) 875-4520
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
—
—
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
04/30/2021
Last updated
04/30/2021
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