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General NPI Number Information
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NPI Number | 1336515832
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Entity Type | Organization
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Legal Business Name | HIGHLAND PARK SENIOR CARE 3, LLC
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Dates
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Enumeration Date | 08/19/2015
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Last Update Date | 09/03/2025
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Provider Practice Location Address
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Address Line | 905 PEGUES PL
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City | LONGVIEW
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State | TX
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Zip | 75601-4027
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Country | US
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Telephone | 903-753-1000
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Fax | 903-753-1218
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Provider Business Mailing Address
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Address Line | 905 PEGUES PL
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City | LONGVIEW
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State | TX
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Zip | 75601-4027
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Country | US
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Telephone | 903-753-1000
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Fax | 903-753-1218
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Authorized Official
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Title or Position | CHIEF QUALITY & COMPLIANCE OFFICER
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Name | MOLLY MCDONALD
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Credential |
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Telephone | 218-791-9401
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 005398
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License Number State | TX
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