Provider Demographics
NPI:1942328844
Name:DENTON ASSISTED LIVING, L.P.
Entity Type:Organization
Organization Name:DENTON ASSISTED LIVING, L.P.
Other - Org Name:CARRIAGE HOUSE ASSISTED LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:REPRESENTATIVE
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-861-8442
Mailing Address - Street 1:1615 W ABRAM ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-1788
Mailing Address - Country:US
Mailing Address - Phone:817-861-8442
Mailing Address - Fax:817-274-8679
Practice Address - Street 1:1357 BERNARD ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-7129
Practice Address - Country:US
Practice Address - Phone:817-861-8442
Practice Address - Fax:817-549-9881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-27
Last Update Date:2021-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX001001159310400000X
TX117726310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117726OtherLICENSE NUMBER
TX030109OtherFACILITY ID
TX001001159OtherPROVIDER NUMBER WITH TMHP