Organization
VINTAGE SCC LLC
Active
Other names
Vintage Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JASON PRICE (SENIOR VICE PRESIDENT)
(949) 436-4343
Entity
Organization
Contact information
Practice address
205 N BONNIE BRAE ST, DENTON, TX 76201-3766
(940) 373-4766
(940) 320-6645
Mailing address
205 N BONNIE BRAE ST, DENTON, TX 76201-3766
(940) 373-4766
(940) 320-6645
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000544
FACILITY ID
TX
05
—
001017205
—
TX
Enumeration date
12/08/2008
Last updated
09/04/2020
Update your record
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