Organization
MANOR ASSISTED CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEITH POWELL (MANAGING MEMBER)
(972) 224-4015
Entity
Organization
Contact information
Practice address
6723 ATHA DR, DALLAS, TX 75217-5664
(214) 490-6103
Mailing address
1472 N HAMPTON RD, STE 111, DESOTO, TX 75115-3001
(972) 224-4015
(972) 224-4339
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
123891
TX
Other
Enumeration date
10/01/2008
Last updated
10/01/2008
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