Provider Demographics
NPI:1255846937
Name:CEDAR SENIOR LIVING, INC.
Entity Type:Organization
Organization Name:CEDAR SENIOR LIVING, INC.
Other - Org Name:CEDAR HILL ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:602 E BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2260
Mailing Address - Country:US
Mailing Address - Phone:972-291-5000
Mailing Address - Fax:972-291-5046
Practice Address - Street 1:602 E BELT LINE RD
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2260
Practice Address - Country:US
Practice Address - Phone:972-291-5000
Practice Address - Fax:972-291-5046
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-04
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility