Provider Demographics
NPI:1114259413
Name:ATMA II ASSISTANT LIVING FACILITY
Entity Type:Organization
Organization Name:ATMA II ASSISTANT LIVING FACILITY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:CARLA
Authorized Official - Middle Name:PATRICE
Authorized Official - Last Name:BORDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-760-0948
Mailing Address - Street 1:4201 BACCARAT DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-6649
Mailing Address - Country:US
Mailing Address - Phone:214-760-0948
Mailing Address - Fax:
Practice Address - Street 1:910 ELMVALE CT
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-3526
Practice Address - Country:US
Practice Address - Phone:972-409-2820
Practice Address - Fax:972-742-5892
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-11
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125231310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility