Organization
AWAL 2012 OPCO, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WAYNE POWELL (PRESIDENT)
(817) 386-8888
Entity
Organization
Contact information
Practice address
3801 HULEN ST, SUITE 202, FT WORTH, TX 76107-7202
(817) 386-8888
(817) 549-0020
Mailing address
1004 E COKE RD, WINNSBORO, TX 75494-3536
(817) 386-8888
(817) 549-0020
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
104275
TX
Other
Enumeration date
01/08/2013
Last updated
03/04/2013
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