Provider Demographics
NPI:1184410581
Name:SKILLS AND FIT RESIDENTIAL LIVING FOR THE AGEING POST-STROKE AND MEMOR
Entity type:Organization
Organization Name:SKILLS AND FIT RESIDENTIAL LIVING FOR THE AGEING POST-STROKE AND MEMOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATIONS OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TENORIA
Authorized Official - Middle Name:TWANEHE
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-885-5680
Mailing Address - Street 1:5223 ELK RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76207-1956
Mailing Address - Country:US
Mailing Address - Phone:314-885-5680
Mailing Address - Fax:
Practice Address - Street 1:5223 ELK RIDGE DR
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76207-1956
Practice Address - Country:US
Practice Address - Phone:314-885-5680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-15
Last Update Date:2025-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities