Healthcare Provider Details

I. General information

NPI: 1205471711
Provider Name (Legal Business Name): ALMONTE CARE OF GRAPEVINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2019
Last Update Date: 11/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 AUTUMN DR
GRAPEVINE TX
76051-3103
US

IV. Provider business mailing address

525 GRANT PARK CT
FRANKLIN TN
37067-7316
US

V. Phone/Fax

Practice location:
  • Phone: 817-488-8585
  • Fax:
Mailing address:
  • Phone: 949-412-8233
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LOGAN SEXTON
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 949-412-8233