Provider Demographics
NPI:1790355485
Name:MES AMIS LIVING HOME, INC
Entity Type:Organization
Organization Name:MES AMIS LIVING HOME, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:
Authorized Official - First Name:ELLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLINTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-591-1706
Mailing Address - Street 1:818 HONTLEY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-6150
Mailing Address - Country:US
Mailing Address - Phone:469-693-5375
Mailing Address - Fax:682-518-6355
Practice Address - Street 1:818 HONTLEY DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-6150
Practice Address - Country:US
Practice Address - Phone:469-693-5375
Practice Address - Fax:682-518-6355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-25
Last Update Date:2021-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility