Wpal 2015 LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

WPAL 2015 LLC

Practice address

178 Crown Pointe Blvd
Willow Park, TX 76087

Phone

(817) 386-8326

NPI assigned

Aug 3, 2016

Organization subpart

No

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

Authorized official

Name

Lawrence Wayne Powell

Title

Member

Phone

(817) 386-8888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470182400000",
    "number": "1760935068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 W VICKERY BLVD",
            "address_2": "SUITE 101",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761076492",
            "telephone_number": "817-386-8888",
            "fax_number": "817-386-8324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "178 CROWN POINTE BLVD",
            "city": "WILLOW PARK",
            "state": "TX",
            "postal_code": "76087",
            "telephone_number": "817-386-8326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WPAL 2015 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "WAYNE",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "817-386-8888"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willow Park Home Health Care Services, Inc.
• Johnny M Wilson, M.D.
• Braden Alexander Wood
• Kayla Wood
• Russell S Wood, PH.D.
• Tifani Leigh Yancey, PTA
• Amber Young
• Dawn Marie Young
• Randy E Young, PTA, CPT
• Maria Zapata Guillen

• Assisted Living Facility in Willow Park, TX
• Providers in Willow Park, 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 Aug 3, 2016; 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.