A Roosevelt Residential Care
Assisted Living Facility in Dallas, TX. Organization (NPI-2).
NPI number1962125302
StatusActive
Last updated in NPPESSep 21, 2022
Details
- NPI
- 1962125302
- Entity type
- Organization (NPI-2)
- Legal business name
- A Roosevelt Residential Care
- Organization subpart
- No
- Enumeration date
- Sep 21, 2022
- Certification date
- Sep 19, 2022
- Last updated
- Sep 21, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 310400000X | Assisted Living Facility | – | – | Yes |
Other names
- A. Roosevelt Residential Care (Other Name)
Practice location
5117 Rocky Ridge RdDallas, TX 75241-1023
Phone 214-434-1583
Mailing address
Po Box 398706Dallas, TX 75339-8706
Phone 214-850-8318
Authorized official
Glaster Wheeler Hicks
Owner/Manager
2148508318
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