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General NPI Number Information
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NPI Number | 1053547687
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Entity Type | Organization
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Legal Business Name | BRIXTON VILLAGE FOR THE ELDERLY INC
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Dates
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Enumeration Date | 06/10/2009
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 750 LOWE DR
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City | CEDAR HILL
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State | TX
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Zip | 75104-9140
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Country | US
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Telephone | 972-293-8367
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Fax | 972-293-8317
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Provider Business Mailing Address
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Address Line | 2727 HENRY STREET
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City | LANCASTER
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State | TX
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Zip | 75134
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Country | US
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Telephone | 972-224-8367
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Fax | 972-293-8317
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Authorized Official
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Title or Position | MANAGER
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Name | ADEYINKA ADEOYE
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Credential |
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Telephone | 972-224-8367
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | 127028
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License Number State | TX
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