Organization
MKG HOLDINGS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH JAMES GREEN (GENERAL MANAGER/ADMINISTRATOR)
(469) 387-9632
Entity
Organization
Contact information
Practice address
2113 EL PASO ST, GRAND PRAIRIE, TX 75051-1231
(469) 387-9632
Mailing address
4309 MILLINGTON DR, HIGHLAND VILLAGE, TX 75077-7913
(469) 387-9632
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
05/27/2015
Last updated
05/27/2015
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