MEDICARE: JAY HOBBS FOUNDATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	314000000X	Skilled Nursing Facility		TX
2	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1346543477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JAY HOBBS FOUNDATION

Provider Business Mailing Address
First Line	:	6811 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5324
Country	:	US
Telephone Number	:	214-360-0440
Fax Number	:	214-360-0330

Provider Business Practice Location Address
First Line	:	6811 WALNUT HILL LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75230-5324
Country	:	US
Telephone Number	:	214-360-0440
Fax Number	:	214-360-0330

Authorized Official
Title or Position	:	PRESIDENT/OWENER
Name	:	GLENDA HOBBS
Credential	:
Telephone Number	:	214-360-0440

Provider Enumeration Date	:	12/12/2010
Last Update Date	:	12/12/2010

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Directions to “JAY HOBBS FOUNDATION ” Practice Location

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