MEDICARE: L & A CARE, 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
1	310400000X	Assisted Living Facility	141429	TX

General Provider Information

NPI Number	:	1811234271
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	L & A CARE, LLC

Provider Business Mailing Address
First Line	:	308 DAKOTA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4469
Country	:	US
Telephone Number	:	817-538-5200
Fax Number	:	817-642-7018

Provider Business Practice Location Address
First Line	:	308 DAKOTA DR
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76002-4469
Country	:	US
Telephone Number	:	817-538-5200
Fax Number	:	817-642-7018

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MRS. ANGELA JASMINE DATE
Credential	:	LVN
Telephone Number	:	817-538-5200

Provider Enumeration Date	:	01/05/2013
Last Update Date	:	07/27/2015

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