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NPI Code Detail

MEDICARE: EC OPCO IRVING, LLC

MEDICARE: EC OPCO IRVING, LLC
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
1310400000XAssisted Living Facility

General Provider Information

NPI Number : 1356842793
Entity Type Code : Organization
Provider Name (Legal Business Name) : EC OPCO IRVING, LLC
Provider Business Mailing Address
First Line : 500 N HURSTBOURNE PKWY STE 200
Second Line :
City : LOUISVILLE
State : KY
Zip : 40222-3301
Country : US
Telephone Number : 971-213-4234
Fax Number : 866-246-9514
Provider Business Practice Location Address
First Line : 2425 TEXAS DR
Second Line :
City : IRVING
State : TX
Zip : 75062-7027
Country : US
Telephone Number : 972-659-6800
Fax Number :
Authorized Official
Title or Position : CONTROLLER/ECLIPSE (MANAGEMENT CO.)
Name : AMY W FLEMING
Credential :
Telephone Number : 971-337-3922
Provider Enumeration Date : 02/21/2018
Last Update Date : 05/30/2019

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Directions to “EC OPCO IRVING, LLC ” Practice Location

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