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NPI Code Detail

MEDICARE: FRANKLIN PARK CATERED LIVING LLC

MEDICARE: FRANKLIN PARK CATERED LIVING LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1417249962
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRANKLIN PARK CATERED LIVING LLC
Provider Business Mailing Address
First Line : 6350 WINTER PARK DR
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-5363
Country : US
Telephone Number : 817-503-0702
Fax Number :
Provider Business Practice Location Address
First Line : 6350 WINTER PARK DR
Second Line :
City : NORTH RICHLAND HILLS
State : TX
Zip : 76180-5363
Country : US
Telephone Number : 817-503-0702
Fax Number :
Authorized Official
Title or Position : OWNER
Name : LUKE CLASSEN
Credential :
Telephone Number : 817-503-0702
Provider Enumeration Date : 05/03/2011
Last Update Date : 05/03/2011

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