Organization
DALLAS HOME FOR JEWISH AGED, INC.
Active
Other names
The Legacy at Preston Hollow
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRIAN BARNES (CFO)
(972) 468-6171
Entity
Organization
Contact information
Practice address
11409 N CENTRAL EXPY, DALLAS, TX 75243-6678
(214) 363-5100
(241) 363-5133
Mailing address
6101 OHIO DR, SUITE 100, PLANO, TX 75024-2720
(972) 468-6171
(972) 468-6172
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
112773
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001012220
—
TX
01
—
165795901
PART B CO-INSURANCE
TX
Enumeration date
07/02/2007
Last updated
09/30/2013
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