Organization
LAKE LAGOS CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH ANNETTE KNAVEL ISOLA (CEO/PRESIDENT)
(469) 383-4776
Entity
Organization
Contact information
Practice address
1416 COUNTRY CLUB RD, ENNIS, TX 75119-2252
(469) 383-4776
(214) 723-5928
Mailing address
1416 COUNTRY CLUB RD, ENNIS, TX 75119-2252
(469) 383-4776
(214) 723-5928
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
347C00000X
Private Vehicle
—
—
Other
Enumeration date
05/03/2018
Last updated
06/16/2018
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