1295954337 NPI number — ESC - NGH, L.P.

Table of content: (NPI 1295954337)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295954337 NPI number — ESC - NGH, L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ESC - NGH, L.P.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
BROOKDALE LAKE HIGHLANDS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295954337
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
111 WESTWOOD PL STE 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5057
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
615-221-2250
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9715 PLANO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75238-2377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-343-7445
Provider Business Practice Location Address Fax Number:
214-343-9193
Provider Enumeration Date:
04/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
LESKOWICZ
Authorized Official First Name:
JOANNE
Authorized Official Middle Name:
K
Authorized Official Title or Position:
SENIOR VICE PRESIDENT
Authorized Official Telephone Number:
414-918-5000

Provider Taxonomy Codes

  • Taxonomy code: 310400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: F500152140 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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