Provider Demographics
NPI:1346975158
Name:SCAL KINGSLAND LLC
Entity Type:Organization
Organization Name:SCAL KINGSLAND LLC
Other - Org Name:WINDCHIME AT THE VILLAGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:INFOADMIN OFCMGR
Authorized Official - Prefix:MS
Authorized Official - First Name:MUNDEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:CHILDERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-304-6801
Mailing Address - Street 1:2501 E HEBRON PKWY STE 100C
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4468
Mailing Address - Country:US
Mailing Address - Phone:866-304-6801
Mailing Address - Fax:972-300-3640
Practice Address - Street 1:216 COVENANT LN
Practice Address - Street 2:
Practice Address - City:KINGSLAND
Practice Address - State:TX
Practice Address - Zip Code:78639-5939
Practice Address - Country:US
Practice Address - Phone:866-304-6801
Practice Address - Fax:972-300-3640
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-18
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No385H00000XRespite Care FacilityRespite Care