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General NPI Number Information
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NPI Number | 1790355485
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Entity Type | Organization
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Legal Business Name | MES AMIS LIVING HOME, INC
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Dates
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Enumeration Date | 06/25/2021
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Last Update Date | 06/25/2021
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Provider Practice Location Address
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Address Line | 818 HONTLEY DR
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City | ARLINGTON
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State | TX
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Zip | 76001-6150
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Country | US
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Telephone | 469-693-5375
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Fax | 682-518-6355
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Provider Business Mailing Address
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Address Line | 818 HONTLEY DR
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City | ARLINGTON
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State | TX
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Zip | 76001-6150
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Country | US
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Telephone | 469-693-5375
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Fax | 682-518-6355
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Authorized Official
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Title or Position | CONSULTANT
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Name | ELLEN CLINTON
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Credential |
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Telephone | 817-591-1706
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311Z00000X
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Taxonomy Name | Custodial Care Facility
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License Number |
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License Number State |
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