Preston Hollow

Organization Active NPI Assisted Living Facility · Dallas, TN

NPI 1316168446 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1316168446
Entity type
Organization (NPI type 2)
Primary specialty
Assisted Living Facility 310400000X
Legal business name
PRESTON HOLLOW
Practice address
4205 West Northwest Hwy
Dallas, TN 75220
Phone
(214) 357-7900
Fax
(503) 485-1279
NPI assigned
May 2, 2007
Organization subpart
No

Authorized official

Name
Jon Harder
Title
Ceo President
Phone
(503) 485-8697

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2253797Parsons House Preston Hollow
4205 W Northwest Hwy, Dallas, TX 75220
Certificate of waiverFeb 23, 2028

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X Yes

Addresses

Primary practice location

4205 West Northwest Hwy
Dallas, TN 75220

Mailing address

PO Box 3006
Sslem, OR 97302
Phone (503) 485-8697

Other providers in Dallas, TN

All providers in Dallas, TN · Assisted Living Facility in Tennessee

Sources for this page

Verify at the official NPI Registry.