Healthcare Provider Details

I. General information

NPI: 1659595536
Provider Name (Legal Business Name): ESC IV, LP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/21/2020
Certification Date: 08/21/2020
Deactivation Date: 06/03/2008
Reactivation Date: 03/12/2010

III. Provider practice location address

1808 W LOOP 250 NORTH
MIDLAND TX
79705
US

IV. Provider business mailing address

111 WESTWOOD PL STE 400
BRENTWOOD TN
37027-5057
US

V. Phone/Fax

Practice location:
  • Phone: 432-687-0460
  • Fax: 432-687-0355
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