21st Century Living Centers

NPI #1760673164 in Southlake, Texas

Provider Information

NPI Number
1760673164
Entity Type
Organization
Organization Name
21st Century Living Centers
Primary Specialty
Intermediate Care Facility, Intellectual Disabilities
Enumeration Date
Aug 9, 2007
Last Updated
Aug 9, 2007

Practice Location

Address
2410 TAYLOR ST
State
Texas
ZIP Code
76092-3316
Phone
(817) 424-3338

Authorized Official

Name
MICHELLE DEANNE NEAL
Title
ADMIN/ASSISTANT QMRP
Phone
(817) 481-5368

Specialties & Taxonomy Codes

Specialty
Intermediate Care Facility, Intellectual Disabilities

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