Organization
TCG BENBROOK AL, LLC
Active
Parent organization
COVENANT GROUP OF TEXAS, LP
Other names
Mirabella Assisted Living
Organization subpart
Yes
Provider details
NPI number
Legal business name
COVENANT GROUP OF TEXAS, LP
Authorized official
MR. BRYAN D. MCCALEB (PRESIDENT)
(817) 446-4792
Entity
Organization
Contact information
Practice address
4242 BRYANT IRVIN RD, COVENANT PLACE OF BURLESON, LP, BENBROOK, TX 76109-4222
(817) 763-0088
(817) 763-8841
Mailing address
1200 SUMMIT AVE, SUITE 444, FORT WORTH, TX 76102-4403
(817) 446-4792
(817) 446-0923
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
000619
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001014575
CBA VENDOR NUMBER
TX
Enumeration date
04/16/2007
Last updated
02/17/2015
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us