Provider Demographics
NPI:1972885572
Name:OPEN DOORS RCH/ADCC/LLC
Entity Type:Organization
Organization Name:OPEN DOORS RCH/ADCC/LLC
Other - Org Name:OPEN DOORS ADULT DAY CARE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:MAHONEY
Authorized Official - Last Name:GOODWIN
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:972-217-2095
Mailing Address - Street 1:501 N COLLEGE ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-3361
Mailing Address - Country:US
Mailing Address - Phone:972-217-2095
Mailing Address - Fax:972-923-0907
Practice Address - Street 1:501 N COLLEGE ST
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-3361
Practice Address - Country:US
Practice Address - Phone:972-217-2095
Practice Address - Fax:972-923-0907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-09
Last Update Date:2011-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX132286311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home