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General NPI Number Information
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NPI Number | 1427905793
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Entity Type | Organization
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Legal Business Name | TEDS HOUSE LLC
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Dates
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Enumeration Date | 03/14/2026
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Last Update Date | 03/14/2026
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Provider Practice Location Address
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Address Line | 1460 ELMWOOD AVE
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City | FORT WORTH
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State | TX
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Zip | 76104-5737
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Country | US
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Telephone | 817-454-9882
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Fax |
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Provider Business Mailing Address
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Address Line | 8101 BOAT CLUB RD STE 240-187
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City | FORT WORTH
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State | TX
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Zip | 76179-3630
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Country | US
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Telephone | 833-466-3777
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Fax |
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | MR. EMERSON WILMORE
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Credential |
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Telephone | 833-466-3777
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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 |
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License Number State |
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