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Organization

MANOR ASSISTED CARE LLC

Active
Other names
Manor Care EMS
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH A POWELL (MANAGING MEMBER)
(972) 224-4015
Entity
Organization

Contact information

Practice address
104 CHOWNING DR, SUITE 104, DESOTO, TX 75115-4900
(972) 224-4015
(972) 224-4339
Mailing address
PO BOX 425, CEDAR HILL, TX 75106-0425
(972) 224-4015
(972) 224-4339

Taxonomy

Speciality
Code
Description
License number
State
341600000X
Ambulance
Primary
1000229
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
201118101
TX
Enumeration date
12/09/2008
Last updated
11/30/2009
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