Organization
FREDISOLO ANNOINTED HOMES
Active
Other names
FREDISOLO ANNOINTED HOMES
Organization subpart
No
Provider details
NPI number
Authorized official
FREDICA KIAWU LVN (DIRECTOR)
(214) 753-9396
Entity
Organization
Contact information
Practice address
1400 PARKWOOD TRL, MESQUITE, TX 75149-7604
(214) 753-9396
(972) 222-9039
Mailing address
1400 PARKWOOD TRL, MESQUITE, TX 75149-7604
(214) 753-9396
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105435
—
TX
Enumeration date
08/25/2020
Last updated
10/16/2020
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