Organization
MG AL GRAND PRAIRIE LLC
Active
Other names
Mayberry Gardens
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIAN HEWITT (OWNER)
(972) 213-8135
Entity
Organization
Contact information
Practice address
540 E POLO RD BLDG 3, GRAND PRAIRIE, TX 75052-3503
(972) 975-9044
Mailing address
3272 N GARLAND AVE, GARLAND, TX 75040-3207
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
—
Other
Enumeration date
05/29/2020
Last updated
06/10/2020
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