Provider Demographics
NPI:1861884942
Name:PROXIMITY ASSISTED LIVING SERVICES INC.
Entity type:Organization
Organization Name:PROXIMITY ASSISTED LIVING SERVICES INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:OSASOGIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ERHABOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN/BSN/
Authorized Official - Phone:972-832-8987
Mailing Address - Street 1:505 BENTON DR
Mailing Address - Street 2:#7210
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-6325
Mailing Address - Country:US
Mailing Address - Phone:972-832-8987
Mailing Address - Fax:214-723-7020
Practice Address - Street 1:505 BENTON DR
Practice Address - Street 2:#7210
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-6325
Practice Address - Country:US
Practice Address - Phone:972-832-8987
Practice Address - Fax:214-723-7020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility