FREDISOLO ANNOINTED HOMES (NPI# 1639782105) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1639782105 |
| Entity Type | Organization |
| Organization Name | FREDISOLO ANNOINTED HOMES |
| Other Organization Name | FREDISOLO ANNOINTED HOMES |
| Practice Address |
1400 Parkwood Trl Mesquite TX 75149-7604 |
| Practice Telephone | 2147539396 |
| Practice Fax Number | 9722229039 |
| Mailing Telephone | 2147539396 |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-10-16 |
| Authorized Official Name | FREDICA KIAWU (DIRECTOR) |
| Authorized Official Telephone | 2147539396 |
| Authorized Official Credential | LVN |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 385H00000X | Respite Care | Respite Care Facility | ||
| Y | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 105435 | 05 |
| Other Name | Type Code |
|---|---|
| Fredisolo Annointed Home | Doing Business As Name - Organization |
| FREDISOLO ANNOINTED HOMES | Doing Business As Name - Organization |
| Street Address |
1400 PARKWOOD TRL |
| City | MESQUITE |
| State | TX |
| Zip Code | 75149-7604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891340642 | Michael Ryan Tong | Pharmacist | 300 West Kearney, Mesquite, TX 75149 | 2019-08-08 |
| 1720548118 | Life Specialty Pharmacy, Inc. | Pharmacy | 949 W. Kearney St., Suite 107, Mesquite, TX 75149 | 2019-03-21 |
| 1851857304 | Foursquare Texas 16 LLC | Skilled Nursing Facility | 750 Highway 352, Mesquite, TX 75149 | 2019-02-20 |
| 1629561477 | Christina Yvette Smith | Nurse Practitioner | 1336 N Galloway Ave Ste 124, Mesquite, TX 75149 | 2018-06-07 |
| 1356844484 | D&b Dentistry, Pllc | Clinic/Center | 5550 South Buckner Blvd., Ste 270, Mesquite, TX 75149 | 2018-03-15 |
| 1811426216 | Higher Ground Services LLC | In Home Supportive Care | 624 Yosemite Trail, Mesquite, TX 75149 | 2017-06-08 |
| 1275067977 | Wal-mart Stores Texas, LLC | Durable Medical Equipment & Medical Supplies | 1951 Military Parkway, Mesquite, TX 75149 | 2017-04-19 |
| 1922530591 | Johnny Staton | Physician Assistant | 1208 Paintbrush St, Mesquite, TX 75149 | 2017-04-01 |
| 1811432115 | Fastpass Ucm, Pllc | Emergency Medicine | 1080 E Cartwright Rd, Suite 120, Mesquite, TX 75149 | 2016-12-22 |
| 1508309170 | Code 3 Emergency Partners At Mesquite, LLC | Clinic/Center | 1080 E Cartwright Rd Ste 100, Mesquite, TX 75149 | 2016-11-29 |
| Find all providers in zip 75149 | ||||
| Taxonomy Code | 310400000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386012912 | Quinton Middleton | Assisted Living Facility | 1004 Kory Dr, Mesquite, TX 75149-6978 | 2015-09-14 |
| 1649662974 | Christian Care Centers, Inc. | Assisted Living Facility | 950 Wiggins Pkwy, Mesquite, TX 75150-1400 | 2015-02-24 |
| 1386036614 | Chrstian Care Centers, Inc. | Assisted Living Facility | 1010 Wiggins Pkwy, Mesquite, TX 75150-7410 | 2015-02-24 |
| 1396154068 | Fredica Kiawu | Assisted Living Facility | 1400 Parkwood Trail, Mesquite, TX 75149 | 2014-08-07 |
| 1821237850 | Mason's Personal Care Homes and Alf | Assisted Living Facility | 1819 Arapaho Trl, Mesquite, TX 75149-6676 | 2009-02-15 |
| 1164549952 | Cambridge Court Assisted Living Limited Partnership | Assisted Living Facility | 711 Matador Ln, Mesquite, TX 75149-8830 | 2007-03-25 |
| 1215053707 | Assisted Living Concepts Inc | Assisted Living Facility | 3700 Oates Drive, Mesquite, TX 75150 | 2007-03-22 |
| 1306832191 | Willowbend Nursing and Rehabilitation Lp | Assisted Living Facility | 2231 Hwy 80 E, Mesquite, TX 75150-5510 | 2005-09-27 |
| 1154790244 | Serenity Streams | Assisted Living Facility | 1004 Kory Dr, Mesquite, TX 75149-6978 | 2015-09-18 |
| 1922420132 | Ccal 2013 Re, LLC | Assisted Living Facility | 711 Matador Ln, Mesquite, TX 75149-8830 | 2014-01-08 |
| Find all providers in MESQUITE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.