Provider Demographics
NPI:1750559324
Name:PREMIER COUNTRY HAVEN ASSISTED LIVING, INC.
Entity type:Organization
Organization Name:PREMIER COUNTRY HAVEN ASSISTED LIVING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HUNTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-729-9094
Mailing Address - Street 1:13812 HIRAM RD
Mailing Address - Street 2:
Mailing Address - City:WILLS POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75169-8652
Mailing Address - Country:US
Mailing Address - Phone:214-729-9094
Mailing Address - Fax:800-878-1268
Practice Address - Street 1:13812 HIRAM RD
Practice Address - Street 2:
Practice Address - City:WILLS POINT
Practice Address - State:TX
Practice Address - Zip Code:75169-8652
Practice Address - Country:US
Practice Address - Phone:214-729-9094
Practice Address - Fax:800-878-1268
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility