Healthcare Provider Details

I. General information

NPI: 1760302194
Provider Name (Legal Business Name): DOVE HILL ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2026
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 E STATE HIGHWAY 22
HAMILTON TX
76531-3173
US

IV. Provider business mailing address

4150 INTERNATIONAL PLZ STE 200
FORT WORTH TX
76109-4875
US

V. Phone/Fax

Practice location:
  • Phone: 254-386-3171
  • Fax: 254-386-8261
Mailing address:
  • Phone:
  • 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: MR. GARY BLAKE
Title or Position: MANAGER
Credential:
Phone: 817-386-8410