Basic Information
| Provider Information | |||||||||
| NPI: | 1225105380 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | IRVING ASSISTED LIVING, LTD. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | HEARTHSTONE AT IRVING | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9595 SIX PINES RD | ||||||||
| Address2: | SUITE 6300 | ||||||||
| City: | THE WOODLANDS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773801531 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 2425 TEXAS DR | ||||||||
| Address2: | |||||||||
| City: | IRVING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750627027 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9726596800 | ||||||||
| FaxNumber: | 9726596904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | DASPIT | ||||||||
| AuthorizedOfficialFirstName: | LAURENCE | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | COO AND PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 2813623502 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 310400000X | 117724 | TX | Y | Nursing & Custodial Care Facilities | Assisted Living Facility |
No ID Information.