Legacy Of Dallas

NPI 1265654305 - Assisted Living Facility - 310400000X

NPI Details
NPI 1265654305
Enumeration Date 05/02/2007
Last Updated 07/08/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name JON JON
Position PRESIDENT
Phone (678) 363-0777
Fax
Practice Location
101 MERCHANTS DRIVE
DALLAS GA, 30132, US
Phone (678) 363-0777
Fax
Business Location
PO BOX 3006
SALEM OR, 97302, US
Phone (503) 485-8697
Fax (503) 485-1279
Toxanomy
Taxonomy Code 310400000X
License State
License Number
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According to our database, Legacy Of Dallas NPI is 1265654305, taxonomy code is 310400000X Legacy Of Dallas physically located at 101 Merchants Drive, Dallas GA, 30132. NPI Number 1033115704 has the healthcare provider type.

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1265654305 NPI number is provided on an as is basis without warranty of any kind. 1265654305 is maintained by the National Plan & Provider Enumeration System. The contents of Legacy Of Dallas are for informational purposes only.