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NPI Code Detail

MEDICARE: DALLAS HOME FOR JEWISH AGED

MEDICARE: DALLAS HOME FOR JEWISH AGED
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 Facility675081TX
2313M00000XNursing Facility/Intermediate Care FacilityTX
3314000000XSkilled Nursing FacilityTX

General Provider Information

NPI Number : 1790744159
Entity Type Code : Organization
Provider Name (Legal Business Name) : DALLAS HOME FOR JEWISH AGED
Provider Business Mailing Address
First Line : 5100 BELT LINE RD
Second Line : SUITE 430
City : DALLAS
State : TX
Zip : 75254-7559
Country : US
Telephone Number : 972-490-7251
Fax Number : 972-387-1281
Provider Business Practice Location Address
First Line : 2525 CENTERVILLE RD
Second Line :
City : DALLAS
State : TX
Zip : 75228-2634
Country : US
Telephone Number : 214-327-4503
Fax Number : 214-320-2683
Authorized Official
Title or Position : PRESIDENT
Name : MR. MICHAEL ELLENTUCK
Credential :
Telephone Number : 972-490-7251
Provider Enumeration Date : 03/22/2006
Last Update Date : 09/11/2025

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Directions to “DALLAS HOME FOR JEWISH AGED ” Practice Location

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