Organization
LANE'S ASSISTED LIVING FACILITY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TOLECHIA V LANE (BUSINESS MANAGER)
(817) 690-9307
Entity
Organization
Contact information
Practice address
2617 CAROLINA DR, FORT WORTH, TX 76123-1661
(817) 689-0125
Mailing address
4937 MADYSON RIDGE DR, FORT WORTH, TX 76133-3847
(817) 690-9307
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
TX
Other
Enumeration date
04/02/2009
Last updated
04/02/2009
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