Provider Demographics
NPI:1538584040
Name:LEE COMMUNITY HOME LIVING INC
Entity type:Organization
Organization Name:LEE COMMUNITY HOME LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:ELIAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SUDOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-660-5080
Mailing Address - Street 1:2321 S BELT LINE RD STE 118
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-4100
Mailing Address - Country:US
Mailing Address - Phone:972-266-8511
Mailing Address - Fax:972-266-8522
Practice Address - Street 1:737 VALLEY SPRING DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-2377
Practice Address - Country:US
Practice Address - Phone:832-660-5080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility