Organization Name: | DESTINY ROSE RESIDENTIAL CARE FACILITY |
NPI Number: | 1386920536 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TONI M MARTIN-MOORE (OWNER/MANAGER) |
Mailing Address: | 1620 Glen Ave Dallas |
State: | TX US |
Postal Code: | 752161727 |
Phone Number: | 2143350627 |
Fax Number: | 2149410308 |
NPI Enumeration Date: | 11/01/2011 |
NPI Last Update Date: | 11/01/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | 00000000000000000000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |