Provider Demographics
NPI:1437694452
Name:BEDFORD ENCORE ADEC LLC
Entity Type:Organization
Organization Name:BEDFORD ENCORE ADEC LLC
Other - Org Name:ENCORE MEMORY CARE DAY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:LESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-663-6811
Mailing Address - Street 1:2928 BLUE QUAIL LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-4161
Mailing Address - Country:US
Mailing Address - Phone:214-264-5468
Mailing Address - Fax:
Practice Address - Street 1:2928 BLUE QUAIL LN
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-4161
Practice Address - Country:US
Practice Address - Phone:214-264-5468
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-29
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care