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General NPI Number Information
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NPI Number | 1154519148
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Entity Type | Organization
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Legal Business Name | VALLEY RANCH DELUXE SENIOR LIVING
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Dates
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Enumeration Date | 10/04/2007
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Last Update Date | 10/04/2007
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Provider Practice Location Address
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Address Line | 8855 VALLEY RANCH PKWY W
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City | IRVING
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State | TX
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Zip | 75063-4630
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Country | US
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Telephone | 972-831-8200
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Fax | 972-831-1515
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Provider Business Mailing Address
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Address Line | 8855 VALLEY RANCH PKWY W
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City | IRVING
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State | TX
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Zip | 75063-4630
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Country | US
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Telephone | 972-831-8200
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Fax | 972-831-1515
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. CONNIE WILLIAMS
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Credential |
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Telephone | 972-831-8200
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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 | 109596
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License Number State | TX
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