Provider Demographics
NPI:1619022704
Name:COLLIN CREEK ASSISTED LIVING CENTER, INC
Entity Type:Organization
Organization Name:COLLIN CREEK ASSISTED LIVING CENTER, INC
Other - Org Name:DAYSPRING ASSISTED LIVING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FACILITY DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TIFFANY
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNCAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-769-1109
Mailing Address - Street 1:6400 CHEYENNE TRL
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-3774
Mailing Address - Country:US
Mailing Address - Phone:972-769-1109
Mailing Address - Fax:972-769-1113
Practice Address - Street 1:6400 CHEYENNE TRL
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-3774
Practice Address - Country:US
Practice Address - Phone:972-769-1109
Practice Address - Fax:972-769-1113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX030165310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility