Organization
WPAL 2015 LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE WAYNE POWELL (MEMBER)
(817) 386-8888
Entity
Organization
Contact information
Practice address
178 CROWN POINTE BLVD, WILLOW PARK, TX 76087
(817) 386-8326
Mailing address
3973 W VICKERY BLVD, SUITE 101, FORT WORTH, TX 76107-6492
(817) 386-8888
(817) 386-8324
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
TX
Other
Enumeration date
08/03/2016
Last updated
08/03/2016
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