Healthcare Provider Details

I. General information

NPI: 1861205429
Provider Name (Legal Business Name): DHC OPCO- RICHARDSON, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2025
Last Update Date: 01/28/2025
Certification Date: 01/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 W SHORE DR
RICHARDSON TX
75080-4046
US

IV. Provider business mailing address

210 MAGNATE DR
LAFAYETTE LA
70508-3871
US

V. Phone/Fax

Practice location:
  • Phone: 972-783-8000
  • Fax:
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: JENNY BONO
Title or Position: CREDENTIALING REP
Credential:
Phone: 337-532-5799