Organization
S TCG BENBROOK AL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HALL (PRESIDENT)
(214) 616-5001
Entity
Organization
Contact information
Practice address
4242 BRYANT IRVIN RD, BENBROOK, TX 76109-4222
(817) 763-0088
Mailing address
801 CHERRY ST STE 2400, FORT WORTH, TX 76102-6824
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
08/31/2017
Last updated
09/13/2017
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