Provider Demographics
NPI:1821237850
Name:MASONS PERSONAL CARE HOMES INC
Entity Type:Organization
Organization Name:MASONS PERSONAL CARE HOMES INC
Other - Org Name:MASON'S PERSONAL CARE HOMES #2
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR / OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BORIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-235-3076
Mailing Address - Street 1:1819 ARAPAHO TRL
Mailing Address - Street 2:
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75149-6676
Mailing Address - Country:US
Mailing Address - Phone:214-235-3076
Mailing Address - Fax:972-222-0417
Practice Address - Street 1:1819 ARAPAHO TRL
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75149-6676
Practice Address - Country:US
Practice Address - Phone:972-222-0414
Practice Address - Fax:972-222-0417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-15
Last Update Date:2021-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX119220310400000X
310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility