Provider Demographics
NPI:1740049477
Name:BEZALEL ASSISTED LIVING MANAGEMENT LLC
Entity type:Organization
Organization Name:BEZALEL ASSISTED LIVING MANAGEMENT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ADRIENNE
Authorized Official - Middle Name:DENIESE
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-265-2720
Mailing Address - Street 1:598 E INTERSTATE 30
Mailing Address - Street 2:PMB 1049
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189
Mailing Address - Country:US
Mailing Address - Phone:314-265-2720
Mailing Address - Fax:
Practice Address - Street 1:913 HAY LOFT LN
Practice Address - Street 2:
Practice Address - City:ROYSE CITY
Practice Address - State:TX
Practice Address - Zip Code:75189-2494
Practice Address - Country:US
Practice Address - Phone:314-265-2720
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation SpecialistGroup - Multi-Specialty
No320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities