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General NPI Number Information
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NPI Number | 1851104418
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Entity Type | Organization
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Legal Business Name | DHC OPCO- WACO, LLC
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Dates
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Enumeration Date | 01/28/2025
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Last Update Date | 01/28/2025
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Provider Practice Location Address
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Address Line | 1900 W ST HWY 6
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City | WACO
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State | TX
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Zip | 76712-9729
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Country | US
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Telephone | 254-776-9681
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Fax |
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Provider Business Mailing Address
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Address Line | 210 MAGNATE DR
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City | LAFAYETTE
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State | LA
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Zip | 70508-3871
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING REP
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Name | JENNY BONO
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Credential |
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Telephone | 337-532-5799
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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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