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NPI Code Detail

MEDICARE: JSC LAKE HIGHLANDS OPERATIONS, LP

MEDICARE: JSC LAKE HIGHLANDS OPERATIONS, LP
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
1314000000XSkilled Nursing Facility131077TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1770818478
Entity Type Code : Organization
Provider Name (Legal Business Name) : JSC LAKE HIGHLANDS OPERATIONS, LP
Provider Business Mailing Address
First Line : 8615 LULLWATER DR
Second Line :
City : DALLAS
State : TX
Zip : 75238-4754
Country : US
Telephone Number : 214-221-0444
Fax Number :
Provider Business Practice Location Address
First Line : 8615 LULLWATER DR
Second Line :
City : DALLAS
State : TX
Zip : 75238-4754
Country : US
Telephone Number : 214-221-0444
Fax Number :
Authorized Official
Title or Position : AUTHORIZED OFFICER
Name : PAULA PIERCE
Credential :
Telephone Number : 972-899-4401
Provider Enumeration Date : 10/14/2009
Last Update Date : 08/04/2020

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