Provider Demographics
NPI:1083183065
Name:PRESTONWOOD ENCORE ADEC, LLC
Entity Type:Organization
Organization Name:PRESTONWOOD ENCORE ADEC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-428-5400
Mailing Address - Street 1:6505 W PARK BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-6210
Mailing Address - Country:US
Mailing Address - Phone:972-428-5400
Mailing Address - Fax:972-428-5401
Practice Address - Street 1:6505 W PARK BLVD STE 116
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-6210
Practice Address - Country:US
Practice Address - Phone:972-428-5400
Practice Address - Fax:972-428-5401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-19
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care