FOSSIL CREEK MEMORY CARE LLC NPI 1891950762

NPI Information

  • NPI: 1891950762
  • Provider Name: FOSSIL CREEK MEMORY CARE LLC
  • Classification: Assisted Living Facility - 310400000X
  • Entity Type: Organization
  • Other Name: AUTUMN LEAVES OF FOSSIL CREEK
  • Address: 4501 SILVER SAGE DR
    HALTOM CITY, TX
    ZIP 76137
  • Phone: (817) 849-8000

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NPI Details

FOSSIL CREEK MEMORY CARE LLC is an assisted living facility in Haltom City, 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. FOSSIL CREEK MEMORY CARE LLC NPI is 1891950762. The provider is registered as an organization entity type.
The provider Other Name Is Autumn Leaves Of Fossil Creek.

The provider's business location address is:

4501 SILVER SAGE DR
HALTOM CITY, TX
ZIP 76137-825
Phone: (817) 849-8000

The provider's authorized official is Chad Anderson .
The authorized official title is President and has the following contact phone number (214) 239-8400.

The enumeration date for this NPI number is 7/21/2008 and was last updated on 7/21/2008.

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 Facility103208TEXASYes

What is NPI?

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This page was last updated on: 3/30/2025

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