Healthcare Provider Details

I. General information

NPI: 1013675735
Provider Name (Legal Business Name): A PLACE LIKE HOME LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2021
Last Update Date: 11/30/2021
Certification Date: 11/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

302 E OVILLA RD STE B
GLENN HEIGHTS TX
75154-3834
US

IV. Provider business mailing address

302 E OVILLA RD STE B
GLENN HEIGHTS TX
75154-3834
US

V. Phone/Fax

Practice location:
  • Phone: 214-467-5288
  • Fax: 214-330-2147
Mailing address:
  • Phone: 214-533-1334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: SANDRA BEARD
Title or Position: CEO
Credential: RN
Phone: 214-533-1334