Healthcare Provider Details

I. General information

NPI: 1265641054
Provider Name (Legal Business Name): ESC-NGH, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 10/22/2020
Certification Date: 10/22/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2698 SOUTH HULEN STREET
FORT WORTH TX
76109
US

IV. Provider business mailing address

111 WESTWOOD PL STE 400
BRENTWOOD TN
37027-5057
US

V. Phone/Fax

Practice location:
  • Phone: 817-922-9559
  • Fax: 817-922-0050
Mailing address:
  • Phone: 615-221-2250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JOANNE K LESKOWICZ
Title or Position: SENIOR VICE PRESIDENT
Credential:
Phone: 414-918-5000