| NPI | 1356103444 |
|---|---|
| Doing Business As | COPPERAS HOLLOW ASSITED LIVING |
| Entity Type | Organization |
| Authorized Contact | GARY BLAKE Managing Member 817-348-8959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Enumeration Date | 2024-01-25 |
| Last Update Date | 2024-01-25 |