Organization
LCS-AL LLC
Active
Other names
Autumn Leaves
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL J. ANDREASEN (SENIOR VICE PRESIDENT)
(515) 875-4500
Entity
Organization
Contact information
Practice address
1010 EMERALD ISLE DR, DALLAS, TX 75218-3980
(214) 319-9184
Mailing address
1010 EMERALD ISLE DR, DALLAS, TX 75218-3980
(214) 319-9184
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
138394
TX
314000000X
Skilled Nursing Facility
Primary
137363
TX
Other
Enumeration date
06/09/2014
Last updated
05/16/2024
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