MEDICARE: WHITEHOUSE ESTATES - LAKEWOOD

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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1417881517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WHITEHOUSE ESTATES - LAKEWOOD

Provider Business Mailing Address
First Line	:	8350 N CENTRAL EXPY STE M1018
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-1600
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6850 GASTON AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-4030
Country	:	US
Telephone Number	:	214-368-2225
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL ASHY
Credential	:
Telephone Number	:	214-368-2225

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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