| NPI | 1336543081 |
|---|---|
| Doing Business As | GRAPEVINE MEDICAL LODGE |
| Entity Type | Organization |
| Authorized Contact | JASON L WREN CEO/Administrator 940-627-5921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2014-10-09 |
| Last Update Date | 2021-08-12 |