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General NPI Number Information
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NPI Number | 1346375631
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Entity Type | Organization
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Legal Business Name | QUILTED CARE--TEXAS, LIMITED PARTNERSHIP
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Dates
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Enumeration Date | 02/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2601 TANDY AVE
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City | FORT WORTH
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State | TX
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Zip | 76103-2552
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Country | US
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Telephone | 817-535-1253
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Fax | 817-536-0177
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Provider Business Mailing Address
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Address Line | 2601 TANDY AVENUE
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City | FORT WORTH
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State | TX
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Zip | 76103
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Country | US
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Telephone | 817-535-1253
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Fax | 817-536-0177
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | THOMAS J WITT JR.
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Credential |
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Telephone | 505-797-8735
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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 | 000964
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License Number State | TX
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