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General NPI Number Information
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NPI Number | 1164058996
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Entity Type | Organization
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Legal Business Name | BROOKHOLLOW SENIOR LIVING LLC
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Dates
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Enumeration Date | 03/12/2020
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Last Update Date | 06/11/2025
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Provider Practice Location Address
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Address Line | 3202 S WILLIS ST
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City | ABILENE
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State | TX
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Zip | 79605-6650
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Country | US
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Telephone | 325-437-6303
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Fax |
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Provider Business Mailing Address
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Address Line | 3202 S WILLIS ST
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City | ABILENE
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State | TX
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Zip | 79605-6650
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Country | US
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Telephone | 325-437-6303
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Fax |
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Authorized Official
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Title or Position | SECRETARY
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Name | AMBER TUELLER
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Credential |
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Telephone | 208-207-2726
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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 |
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License Number State |
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