MG AL GRAND PRAIRIE LLC NPI 1790309482

NPI Information

  • NPI: 1790309482
  • Provider Name: MG AL GRAND PRAIRIE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Doing Business As: MAYBERRY GARDENS
  • Address: 540 E POLO RD BLDG 3
    GRAND PRAIRIE, TX
    ZIP 75052
  • Phone: (972) 975-9044

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NPI Details

MG AL GRAND PRAIRIE LLC is an assisted living facility in Grand Prairie, TX. The provider is 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. MG AL GRAND PRAIRIE LLC NPI is 1790309482. The provider is registered as an organization entity type.
The provider Is Doing Business As Mayberry Gardens.

The provider's business location address is:

540 E POLO RD BLDG 3
GRAND PRAIRIE, TX
ZIP 75052-503
Phone: (972) 975-9044

The provider's authorized official is Adrian Hewitt .
The authorized official title is Owner and has the following contact phone number (972) 213-8135.

The enumeration date for this NPI number is 5/29/2020 and was last updated on 6/10/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1310400000XAssisted Living FacilityYes

What is NPI?

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This page was last updated on: 11/21/2025

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