Organization
PINE LODGE BUSINESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NISSA NASIR HUSAIN (OWNER)
(214) 606-0550
Entity
Organization
Contact information
Practice address
1667 W PLANO PKWY, PLANO, TX 75075-8666
(214) 606-0550
Mailing address
3639 COPPER STONE DR, DALLAS, TX 75287-6257
(214) 606-0550
Taxonomy
Speciality
Code
Description
License number
State
311500000X
Alzheimer Center (Dementia Center)
Primary
—
—
Other
Enumeration date
12/11/2024
Last updated
12/12/2024
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