Provider Demographics
NPI:1033570890
Name:CHRISTIAN CARE SENIOR LIVING COMMUNITY - ALLEN
Entity Type:Organization
Organization Name:CHRISTIAN CARE SENIOR LIVING COMMUNITY - ALLEN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CIO
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SPENCER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-686-2430
Mailing Address - Street 1:900 WIGGINS PKWY
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-1400
Mailing Address - Country:US
Mailing Address - Phone:972-686-2400
Mailing Address - Fax:
Practice Address - Street 1:560 PRESTIGE CIRCLE
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002
Practice Address - Country:US
Practice Address - Phone:972-686-2400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHRISTIAN CARE CENTERS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility