Provider Demographics
NPI:1134374044
Name:OUR SEASON FAMILY SERVICES, INC
Entity type:Organization
Organization Name:OUR SEASON FAMILY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAYO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-703-8047
Mailing Address - Street 1:PO BOX 801352
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75380-1352
Mailing Address - Country:US
Mailing Address - Phone:214-703-7047
Mailing Address - Fax:972-404-8440
Practice Address - Street 1:5414 VINERIDGE PL
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75044-4640
Practice Address - Country:US
Practice Address - Phone:214-703-8047
Practice Address - Fax:972-404-8440
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX125262310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility