Provider Demographics
NPI:1598160715
Name:PF LW ALF OPS, LLC
Entity Type:Organization
Organization Name:PF LW ALF OPS, LLC
Other - Org Name:LAKEWEST ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:CHANCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-725-2837
Mailing Address - Street 1:1500 WATERS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6011
Mailing Address - Country:US
Mailing Address - Phone:972-899-4401
Mailing Address - Fax:972-899-4460
Practice Address - Street 1:3494 KINGBRIDGE STREET
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212
Practice Address - Country:US
Practice Address - Phone:972-899-4401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-30
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX142829310400000X
314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility