Organization
JACKSBORO ASSISTED LIVING, INC.
Active
Other names
GREYSTONE PARK
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAM T JEWELL (PRESIDENT)
(580) 622-6300
Entity
Organization
Contact information
Practice address
1116 US HIGHWAY 148, JACKSBORO, TX 76458-3439
(940) 567-3057
(940) 567-5782
Mailing address
1116 US HIGHWAY 148, JACKSBORO, TX 76458-3439
(940) 567-3057
(940) 567-5782
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
120111
TX
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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