Provider Demographics
NPI:1164926275
Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Entity Type:Organization
Organization Name:EASTLAND MEMORIAL HOSPITAL DISTRICT
Other - Org Name:THE VILLAGES OF DALLAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER OF MANAGEMENT COMPANY
Authorized Official - Prefix:
Authorized Official - First Name:SOON
Authorized Official - Middle Name:
Authorized Official - Last Name:BURNAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:949-540-1249
Mailing Address - Street 1:550 E ANN ARBOR AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75216-6718
Mailing Address - Country:US
Mailing Address - Phone:214-376-1701
Mailing Address - Fax:
Practice Address - Street 1:550 E ANN ARBOR AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75216-6718
Practice Address - Country:US
Practice Address - Phone:214-376-1701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility