Provider Demographics
NPI:1689922239
Name:BUCKNER RETIREMENT SERVICES, INC.
Entity Type:Organization
Organization Name:BUCKNER RETIREMENT SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SR. VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-758-8036
Mailing Address - Street 1:600 N PEARL ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75201-2822
Mailing Address - Country:US
Mailing Address - Phone:214-758-8000
Mailing Address - Fax:214-758-8153
Practice Address - Street 1:600 N PEARL ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-2822
Practice Address - Country:US
Practice Address - Phone:214-758-8000
Practice Address - Fax:214-758-8153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310400000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility