| NPI | 1396005195 |
|---|---|
| Doing Business As | THE PERIDOT ASSISTED LIVING COMMUNITY |
| Entity Type | Organization |
| Authorized Contact | TRACY ALLEN Director Medicaid Services 214-701-7249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: AZ AL8058C) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |