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General NPI Number Information
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NPI Number | 1801923198
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Entity Type | Organization
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Legal Business Name | THE BRIDGE AT FAIR PARK, LLC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 07/16/2024
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Provider Practice Location Address
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Address Line | 2535 MARTIN LUTHER KING JR BLVD
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City | DALLAS
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State | TX
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Zip | 75215-2306
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Country | US
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Telephone | 214-565-7823
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Fax | 214-565-0246
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Provider Business Mailing Address
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Address Line | 2535 MARTIN LUTHER KING JR BLVD
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City | DALLAS
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State | TX
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Zip | 75215-2306
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Country | US
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Telephone | 214-565-7823
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Fax | 214-565-0246
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | PAULA WATKINS
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Credential |
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Telephone | 214-565-7823
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number |
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License Number State |
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