Provider Demographics
NPI:1598428906
Name:DRAPER SENIOR LIVING, LLC
Entity Type:Organization
Organization Name:DRAPER SENIOR LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:KATHI
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-473-5502
Mailing Address - Street 1:12377 MERIT DR STE 500
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75251-2343
Mailing Address - Country:US
Mailing Address - Phone:214-473-5502
Mailing Address - Fax:214-329-9615
Practice Address - Street 1:11631 S 700 E
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-8288
Practice Address - Country:US
Practice Address - Phone:801-383-2719
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility