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General NPI Number Information
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NPI Number | 1346011301
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Entity Type | Organization
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Legal Business Name | ANEW LIVING LLC
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Dates
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Enumeration Date | 01/09/2024
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Last Update Date | 01/09/2024
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Provider Practice Location Address
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Address Line | 4040 SHADY HOLLOW LN
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City | DALLAS
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State | TX
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Zip | 75233-3601
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Country | US
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Telephone | 817-938-2762
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Fax |
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Provider Business Mailing Address
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Address Line | 1311 N TRAIL DR
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City | CARROLLTON
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State | TX
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Zip | 75006-1416
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Country | US
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Telephone | 817-938-2762
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. KEVIN GILKES SR.
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Credential |
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Telephone | 817-938-2762
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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