Provider Demographics
NPI:1053547687
Name:BRIXTON VILLAGE FOR THE ELDERLY INC
Entity type:Organization
Organization Name:BRIXTON VILLAGE FOR THE ELDERLY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ADEYINKA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-224-8367
Mailing Address - Street 1:2727 HENRY STREET
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134
Mailing Address - Country:US
Mailing Address - Phone:972-224-8367
Mailing Address - Fax:972-293-8317
Practice Address - Street 1:750 LOWE DR
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-9140
Practice Address - Country:US
Practice Address - Phone:972-293-8367
Practice Address - Fax:972-293-8317
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRIXTON INVESTMENTS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-10
Last Update Date:2011-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX127028310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility