Organization
FAITH ASSISTED LIVING GROUP HOME
Active
Other names
Faith Assisted Living Group Home
Organization subpart
No
Provider details
NPI number
Authorized official
MOLUA I BECKE (DIRECTOR OF ADMINITRATION)
(817) 658-0722
Entity
Organization
Contact information
Practice address
5201 WHITEHAVE DR, GARLAND, TX 75043
(817) 658-0722
Mailing address
5201 WHITEHAVE DR, GARLAND, TX 75043
(817) 658-0722
Taxonomy
Speciality
Code
Description
License number
State
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
Primary
8067
TX
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
658067
TX
343800000X
Secured Medical Transport (VAN)
24206663
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8067
TRANSPOTATION
TX
Enumeration date
01/12/2009
Last updated
01/12/2009
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