Provider Demographics
NPI:1417249962
Name:FRANKLIN PARK CATERED LIVING LLC
Entity Type:Organization
Organization Name:FRANKLIN PARK CATERED LIVING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLASSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-503-0702
Mailing Address - Street 1:6350 WINTER PARK DR
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-5363
Mailing Address - Country:US
Mailing Address - Phone:817-503-0702
Mailing Address - Fax:
Practice Address - Street 1:6350 WINTER PARK DR
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-5363
Practice Address - Country:US
Practice Address - Phone:817-503-0702
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-03
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health