FREDISOLO ANNOINTED HOMES NPI 1639782105

NPI Information

NPI: 1639782105
Provider Name: FREDISOLO ANNOINTED HOMES

Doing Business As: FREDISOLO ANNOINTED HOMES

Classification: Assisted Living Facility - 310400000X
Entity Type: Organization
Address:
1400 PARKWOOD TRL
MESQUITE, TX
ZIP 75149
Phone: (214) 753-9396
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FREDISOLO ANNOINTED HOMES is an assisted living facility in Mesquite, TX. The provider is a facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. FREDISOLO ANNOINTED HOMES NPI is 1639782105. The provider is registered as an organization entity type.
The provider Is Doing Business As Fredisolo Annointed Homes.

The provider's business location address is:

1400 PARKWOOD TRL
MESQUITE, TX
ZIP 75149-604
Phone: (214) 753-9396
Fax: (972) 222-9039

The provider's authorized official is Fredica Kiawu .
The authorized official title is Director and has the following contact phone number (214) 753-9396.

The enumeration date for this NPI number is 8/25/2020 and was last updated on 10/16/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	3104A0625X	Assisted Living Facility	Assisted Living, Mental Illness	No
2	385H00000X	Respite Care		No
3	310400000X	Assisted Living Facility		Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	105435	MEDICAID	TEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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