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General NPI Number Information
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NPI Number | 1962400283
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Entity Type | Organization
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Legal Business Name | NORTHWEST SENIOR HOUSING CORPORATION
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Dates
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Enumeration Date | 07/11/2005
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 8502 EDGEMERE RD
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City | DALLAS
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State | TX
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Zip | 75225-3523
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Country | US
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Telephone | 214-615-7045
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Fax | 214-615-7046
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Provider Business Mailing Address
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Address Line | 8502 EDGEMERE RD
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City | DALLAS
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State | TX
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Zip | 75225-3523
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Country | US
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Telephone | 214-615-7045
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Fax | 214-615-7046
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Authorized Official
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Title or Position | ACCOUNTING MANAGER
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Name | MS. DEBORAH A TRAINOR
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Credential | BBA, MES
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Telephone | 214-615-7035
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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 | 114475
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 114476
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License Number State | TX
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