Awal 2012 Opco, LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

104275 Issued in TX

Legal business name

AWAL 2012 OPCO, LLC

Practice address

3801 Hulen St
Suite 202
Ft Worth, TX 76107-7202

Phone

(817) 386-8888

Fax

(817) 549-0020

NPI assigned

Jan 8, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Wayne Powell

Title

President

Phone

(817) 386-8888

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1357603200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1417294661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 E COKE RD",
            "city": "WINNSBORO",
            "state": "TX",
            "postal_code": "754943536",
            "telephone_number": "817-386-8888",
            "fax_number": "817-549-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3801 HULEN ST",
            "address_2": "SUITE 202",
            "city": "FT WORTH",
            "state": "TX",
            "postal_code": "761077202",
            "telephone_number": "817-386-8888",
            "fax_number": "817-549-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AWAL 2012 OPCO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-08",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-386-8888",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": "104275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Assisted Living Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.