Provider Demographics
NPI:1164018644
Name:HP BURLESON OPCO, LLC
Entity Type:Organization
Organization Name:HP BURLESON OPCO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-721-7426
Mailing Address - Street 1:611 NE ALSBURY BLVD
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-2658
Mailing Address - Country:US
Mailing Address - Phone:817-447-4477
Mailing Address - Fax:
Practice Address - Street 1:611 NE ALSBURY BLVD
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-2658
Practice Address - Country:US
Practice Address - Phone:817-447-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2021-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility