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Organization

DESTINY ROSE RESIDENTIAL CARE FACILITY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TONI MARTIN-MOORE (OWNER)
(214) 778-7228
Entity
Organization

Contact information

Practice address
1620 GLEN AVE, DALLAS, TX 75216-1727
(214) 335-0627
(214) 941-0308
Mailing address
PO BOX 543174, GRAND PRAIRIE, TX 75054-3174
(214) 778-7228
(214) 377-5009

Taxonomy

Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
00000000000000000000
TX

Other

Enumeration date
11/01/2011
Last updated
09/21/2021
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