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General NPI Number Information
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NPI Number | 1346578770
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Entity Type | Organization
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Legal Business Name | KONEKTZ LLC
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Dates
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Enumeration Date | 11/23/2009
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Last Update Date | 11/23/2009
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Provider Practice Location Address
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Address Line | 13521 METHOD ST
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City | DALLAS
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State | TX
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Zip | 75243-1409
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Country | US
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Telephone | 972-699-7700
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Fax | 214-452-9938
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Provider Business Mailing Address
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Address Line | 13521 METHOD ST
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City | DALLAS
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State | TX
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Zip | 75243-1409
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Country | US
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Telephone | 972-699-7700
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Fax | 214-452-9938
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Authorized Official
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Title or Position | DIRECTOR
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Name | VICKY FEMI-MICHAELS
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Credential | BA, PGD
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Telephone | 972-699-7700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number | 128040
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 128040
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License Number State | TX
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