Provider Demographics
NPI:1609257716
Name:TEXAS STAR ASSISTED LIVING LLC
Entity Type:Organization
Organization Name:TEXAS STAR ASSISTED LIVING LLC
Other - Org Name:TEXAS STAR ASSISTED LIVING AND MEMORY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-704-7303
Mailing Address - Street 1:3801 HULEN ST STE 202
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-7202
Mailing Address - Country:US
Mailing Address - Phone:817-386-8888
Mailing Address - Fax:
Practice Address - Street 1:650 S GREENVILLE AVE
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75002
Practice Address - Country:US
Practice Address - Phone:214-704-7303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-15
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility