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General NPI Number Information
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NPI Number | 1376706077
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Entity Type | Organization
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Legal Business Name | PRESBYTERIAN VILLAGE NORTH FOREFRONT LIVING
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Dates
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Enumeration Date | 07/03/2008
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Last Update Date | 03/20/2024
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Provider Practice Location Address
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Address Line | 8600 SKYLINE DR
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City | DALLAS
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State | TX
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Zip | 75243-4198
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Country | US
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Telephone | 214-355-9024
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Fax | 214-355-9079
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Provider Business Mailing Address
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Address Line | 8600 SKYLINE DR
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City | DALLAS
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State | TX
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Zip | 75243-4198
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Country | US
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Telephone | 214-355-9001
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Fax | 214-355-9050
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Authorized Official
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Title or Position | CORPORATE COMPLIANCE DIRECTOR
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Name | KAREN KIMBERLY JOHNSON-COOK
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Credential | BSN RN
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Telephone | 214-413-1566
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 000295
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License Number State | TX
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