SOUTHLAKE EDUCATIONAL CENTER
Nursing in Hurst, TX

License number
Texas 1013303
Category
Nursing
Type
Intermediate Care Facility, Mentally Retarded
Owner
Name: MICHELLE DEANNE NEAL
Title: ADMIN/ASSISTANT QMRP
Phone: (817) 481-5368
Address
Address 2
649 Circle Vw SOUTH, Hurst, TX 76054
2695 Lonesome Dove Rd, Grapevine, TX 76092
National Provider ID: 1356531644
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SOUTHLAKE EDUCATIONAL CENTER, INC

Grand Prairie, TX  -  Grapevine, TX

Registration:
Dec 16, 1994
Addresses:
2846 Birmingham Dr, Grand Prairie, TX 75052 (Mailing)
2695 Lonesome Dove Rd, Grapevine, TX 76092
State ID:
0133678100
Business type:
Domestic For-Profit Corporation
Directors:
Connie Leemauk (Partner, Director, President, Treasurer), 2846 Birmingham Dr, Grand Prairie, TX 75052,Wendy K Yates (Secretary, Director), 2829 Rocheser Ct, Grand Prairie, TX 75052,David E. Walsh Director, inactive
Agent:
David E Walsh Sr,1206 Ashmoore Ct, Southlake, TX 76092 (Physical)
TIN:
30117560216

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