Organization
CIVITAS DRA 2016 MANAGMENT LLC
Active
Other names
Dancing River
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WAYNE POWELL JR. (PRESIDENT)
(817) 386-8888
Entity
Organization
Contact information
Practice address
3735 IRA E WOODS AVE, GRAPEVINE, TX 76051-4213
(817) 442-0505
(817) 386-8324
Mailing address
3735 IRA E WOODS AVE, GRAPEVINE, TX 76051-4213
(817) 442-0505
(817) 386-8324
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
140585
TX
Other
Enumeration date
09/27/2016
Last updated
09/27/2016
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