| NPI | 1407889678 |
|---|---|
| Doing Business As | CHEYENNE TRACE |
| Entity Type | Organization |
| Authorized Contact | JAKE HALLSTED President 832-448-3700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: TN ACL0000000124) |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2020-08-22 |