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General NPI Number Information
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NPI Number | 1558589903
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Entity Type | Organization
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Legal Business Name | LAKE ARLINGTON HOLDING COMPANY
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6702 W POLY WEBB RD
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City | ARLINGTON
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State | TX
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Zip | 76016-3615
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Country | US
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Telephone | 817-478-0095
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Fax | 817-478-7628
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Provider Business Mailing Address
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Address Line | 6702 W POLY WEBB RD
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City | ARLINGTON
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State | TX
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Zip | 76016-3615
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Country | US
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Telephone | 817-478-0095
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Fax | 817-478-7628
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Authorized Official
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Title or Position | ADMIN DIRECTOR
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Name | DR. MICHAEL WALKER
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Credential | ED.D.
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Telephone | 817-478-0095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0401X
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Taxonomy Name | Comprehensive Outpatient Rehabilitation Facility (CORF)
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License Number |
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License Number State |
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