Provider Demographics
NPI:1871643593
Name:CALAB INC
Entity Type:Organization
Organization Name:CALAB INC
Other - Org Name:EASTBROOK
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FOY
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:972-647-9103
Mailing Address - Street 1:297 NW 25TH ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75050-4804
Mailing Address - Country:US
Mailing Address - Phone:972-647-9103
Mailing Address - Fax:972-606-4792
Practice Address - Street 1:3313 EASTBROOK DR
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3742
Practice Address - Country:US
Practice Address - Phone:972-686-9478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-12
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX45G3444315P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX001004229OtherPROVIDER NUMBER