MEDICARE: ONLY THE STRONG SURVIVE ASSISTED LIVING

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	310400000X	Assisted Living Facility	101259	TX

General Provider Information

NPI Number	:	1770878753
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ONLY THE STRONG SURVIVE ASSISTED LIVING

Provider Business Mailing Address
First Line	:	3018 WEATHER VANE LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-1736
Country	:	US
Telephone Number	:	214-930-6346
Fax Number	:	972-240-5468

Provider Business Practice Location Address
First Line	:	3018 WEATHER VANE LN
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-1736
Country	:	US
Telephone Number	:	214-930-6346
Fax Number	:	972-240-5468

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MRS. MARILYN H JACKSON
Credential	:
Telephone Number	:	214-930-6346

Provider Enumeration Date	:	06/17/2011
Last Update Date	:	06/17/2011

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